Escitalopram: therapeutic uses and side effects

This substance is one of the most widely used Antidepressant drugs to treat mental disorders.

Selective serotonin reuptake inhibitors are the most widely used antidepressant drugs. In this article we will describe the therapeutic uses and side effects of escitalopram, a very popular SSRI that is especially effective in treating depression and various anxiety disorders because of its precise pharmacological activity.

What is escitalopram?

Escitalopram is an antidepressant drug of the selective serotonin reuptake inhibitor (SSRI) class. Other widely used drugs in this group include sertraline, paroxetine, fluoxetine, fluvoxamine and citalopram, a predecessor of escitalopram, which is very similar to escitalopram..

This psychopharmaceutical was developed between 1997 and 2001 by the pharmaceutical companies H. Lundbeck A/S and Forest Laboratories, which had previous experience in the production of citalopram. It is currently one of the most widely used SSRIs.

It is marketed under different names in many countries around the world. Some of the best known are Cipralex, Lexapro, Esertia, Meridian, Ipran and HeipramA large number of brand names include the term "Escitalopram" in the product name.

Unlike other SSRIs, escitalopram exerts its effect in a highly selective way on serotonin receptors; this means that its interaction with receptors of other neurotransmitters is scarce. For this reason, some authors attribute to it a greater efficacy than other SSRIs in the treatment of severe depression.

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are the most commonly prescribed group of antidepressants. Their effectiveness in treating symptoms of depression and anxiety is attributed to their agonism of different monoamines (a very important type of neurotransmitter): serotonin, noradrenaline and dopamine.

The mechanism of action of SSRIs is not exactly known, although it is known that their effects are associated with the blockade of serotonin reuptake, as their name suggests. These drugs increase the availability of serotonin in the synaptic space by limiting its reabsorption by limiting its reuptake by postsynaptic receptors.

Drugs in this class are primarily used to treat symptoms of depression, although many of them have also been shown to be effective in the management of anxiety disorders, such as generalized anxiety disorder or obsessive-compulsive disorder. Fluoxetine is also prescribed in some cases of bulimia nervosa.

What is it used for?

Like other SSRIs, escitalopram has been shown to be effective in treating multiple symptoms related to anxiety and depression, although it is not approved for use in all countries for the same disorders.

Let's see what are the most common therapeutic uses of escitalopram.

1. Major depressive disorder

Several scientific investigations have demonstrated the efficacy of escitalopram in the treatment of major depressive disorder. Some of the additional uses of this drug are associated with disorders biologically related to depressionIn particular, generalized anxiety disorder, obsessive-compulsive disorder, and bulimia nervosa.

Generalized anxiety disorder 2.

The therapeutic effects of escitalopram in cases of generalized anxiety disorder are significant and rapid; clear improvements in the condition of most patients are detected approximately two months after starting treatment.

Panic disorder

Panic disorder is characterized by the appearance of anguish crisesduring which symptoms such as tachycardia, breathing difficulties and fear of dying appear. It may or may not be accompanied by agoraphobia.

4. Social phobia

In the social phobia appear symptoms of anxiety and avoidance associated with social interaction.. In addition to antidepressants, anxiolytics are sometimes prescribed, particularly beta-blockers and benzodiazepines.

5. Obsessive-compulsive disorder

Escitalopram and some other SSRIs are also commonly used for the treatment of obsessive-compulsive disorder, or OCD, which is diagnosed when anxiety-provoking obsessive thoughts and behavioral rituals aimed at reducing distress are present.

Side effects of escitalopram

The most common side effects of escitalopram use are headache, nausea, nausea and vomiting. headache, nausea, diarrhea and insomnia.. Less common side effects include the occurrence of anxiety, dizziness, fatigue, drowsiness, sweating, dry mouth, constipation, heartburn and stomach gas.

It is also relatively common for sexual dysfunction to develop sexual dysfunctions as a consequence of treatment with escitalopram and other SSRIs, especially decreased desire, anesthesia and anorexia.especially decreased desire, genital anesthesia, arousal disorders, ejaculatory delay and anorgasmia.

Serious adverse reactions that may occur with escitalopram intake, although rare, include seizures, breathing difficulties, heart rhythm disturbances and swelling of the face, hands and ankles.

Precautions and contraindications

Particular caution should be exercised when prescribing escitalopram if the person has cardiac, respiratory, hepatic or renal disorders, as well as if the relevant, as well as if he/she has suffered manic episodes or epileptic seizures.

In children and adolescents, hostile behavior and suicide attempts associated with escitalopram occur more frequently than has been detected in adults; however, these reactions are also possible in older people and are usually detectable by monitoring the effects of treatment during the first few weeks.

Given that there is a certain risk of drug tolerance and dependence, abrupt discontinuation of consumption may lead to the onset of serotonin syndrome. can lead to the appearance of the serotoninergic syndrome characteristic of SSRIs. In this case the most common symptoms are the appearance of depressive reactions, irritability, feelings of dizziness and akathisia.

Its potential for negative interaction with other substances is low compared to that of other SSRIs, in particular paroxetine. It is advisable to avoid taking escitalopram and antidepressants of the monoamine oxidase inhibitor (MAOI) class because of the increased risk of developing serotonergic syndrome.

Bibliographic references:

• Consejo General de Colegios Oficiales de Farmacéuticos. (2009). Mood disorders: depression and anxiety. Strategic plan for the development of pharmaceutical care '09.
• Morán I, Baldirà J, Morocco L, Nogué S. (2011). Clinical toxicology. Madrid: Difusión Jurídica y Temas de Actualidad S.A.
• Spanish Agency of Medicines and Health Products. Use of antidepressant drugs in Spain during the period (2015). 2000-2013. Report on drug utilization [Internet] 2015 [Accessed: August 2, 2018] Available at: http://www.aemps.gob.es/medicamentosUsoHumano/observatorio/docs/antidepresivos2000-2013.pdf