Escitalopram: Uses, Dosage, Side Effects, Precautions and Price in India

Escitalopram is an SSRI antidepressant used to treat depression and generalized anxiety disorder, and it may also be prescribed for panic disorder. This guide covers escitalopram uses, how it works, dosage, how long it takes to work, side effects, precautions, use in pregnancy and breastfeeding, common brands and its approximate price in India.

At a Glance

What is Escitalopram?

Escitalopram is an SSRI antidepressant used to treat depression and anxiety disorders. It selectively inhibits the reuptake of serotonin, which increases the amount of serotonin available between nerve cells.

How Escitalopram Works

Escitalopram selectively blocks serotonin reuptake, which increases serotonin availability in the brain. Over time, this helps reduce symptoms of depression and anxiety. The effect builds gradually and is not immediate.

Escitalopram Uses

• Depression: Used to treat major depressive disorder.
• Generalized anxiety disorder: Used to treat generalized anxiety disorder in the age groups covered by the applicable product labeling.
• Panic disorder: Escitalopram may be prescribed for panic disorder in some clinical settings, depending on local approval and the doctor’s assessment.

Escitalopram Dosage

The information below is general reference only. Your doctor decides the dose that is right for you. Do not change or stop your dose on your own.

• Adults: Treatment usually starts at 10 mg once daily. Depending on response and tolerability, the doctor may increase it to 20 mg once daily. Not everyone needs or should take 20 mg.
• Adolescents with depression (12 years and older): The starting dose may be 10 mg once daily, with an increase to 20 mg/day only when clinically appropriate and after adequate observation.
• Children with generalized anxiety disorder (7 years and older): Labeling for applicable products supports use from 7 years of age, with a 10 mg starting dose.
• Pediatric use in general: It depends on the condition and the specific product labeling, and should only be decided by a doctor.
• Liver impairment: A dose of 10 mg once daily is recommended.
• Older adults: They are generally started at 10 mg once daily where applicable, and dose selection needs extra caution.

How to Take Escitalopram

Take it once daily, in the morning or evening, with or without food. Taking it at the same time each day can help. Continue treatment as prescribed and discuss any concerns with your doctor rather than stopping on your own.

How Long Does Escitalopram Take to Work?

Some improvement may be noticed within a few weeks, but the full benefit can take longer. If you feel it is not working or are troubled by side effects, speak to your doctor instead of stopping the medicine.

Escitalopram Side Effects

• Common: Nausea, insomnia, dizziness, sexual dysfunction.
• Important safety issues (described in the sections below): suicidal thoughts or behavior, serotonin syndrome, QT prolongation and abnormal heart rhythm, low sodium (hyponatremia), increased bleeding risk, mania or hypomania in susceptible people, and discontinuation symptoms after stopping suddenly.

Driving and alertness: Escitalopram can cause drowsiness and may affect judgment, thinking or reaction time. Do not drive or operate machinery until you know how it affects you, and avoid alcohol, which can make these effects worse.

Escitalopram Precautions

Suicidal Thoughts and Behavior

Antidepressants can increase the risk of suicidal thoughts and behavior in children, adolescents and young adults. The risk is particularly important when starting treatment or changing the dose. Seek urgent medical attention for new or worsening suicidal thoughts, thoughts of self-harm, severe agitation or unusual changes in behavior.

QT Prolongation and Heart Rhythm

Escitalopram can prolong the QT interval and may increase the risk of abnormal heart rhythms, particularly at higher doses or in people with certain heart conditions, electrolyte abnormalities or other medicines that prolong the QT interval. Tell your doctor about:

• heart rhythm problems
• fainting
• low potassium or magnesium
• other medicines that prolong the QT interval

Low Sodium (Hyponatremia)

Escitalopram can rarely cause low blood sodium, especially in older adults or people taking medicines that also lower sodium. Symptoms can include headache, confusion, weakness and unsteadiness, and seizures in severe cases. Seek medical advice if these occur.

Bleeding Risk

Escitalopram can increase the risk of bleeding, especially when combined with aspirin, NSAIDs, warfarin, other anticoagulants or antiplatelet medicines. Discuss these combinations with your doctor or pharmacist.

Serotonin Syndrome and Interactions

Serotonin syndrome is a serious reaction that can occur when escitalopram is combined with other serotonergic medicines, although it can also occur on its own. The risk increases with MAOIs, other serotonergic antidepressants, tramadol, triptans, lithium and other medicines that increase serotonin. Always tell your doctor about all your medicines and supplements.

Bipolar Disorder and Mania

Doctors assess for bipolar disorder or previous mania or hypomania before starting an antidepressant, because antidepressants can precipitate mania or hypomania in susceptible people.

When Escitalopram Must Not Be Used

• With an MAOI. Allow at least 14 days after stopping an MAOI before starting escitalopram, and at least 14 days after stopping escitalopram before starting an MAOI, unless the applicable product labeling specifies otherwise.
• With linezolid or intravenous methylene blue
• With pimozide
• If you are allergic to escitalopram or citalopram

Stopping Escitalopram

Do not stop suddenly. Abrupt discontinuation can cause dizziness, sensory disturbances, sleep problems, anxiety, irritability, nausea and flu-like symptoms. The dose should generally be reduced gradually under medical guidance.

Older Adults, Kidney and Liver Function

Older adults may be more susceptible to adverse effects such as low sodium, and dose selection may need extra caution. Liver function (and kidney function) may affect treatment decisions, so tell your doctor about any liver or kidney problems.

Escitalopram in Pregnancy

Escitalopram may be used during pregnancy when clinically needed. Treatment decisions should balance the mother’s mental health needs with potential pregnancy and newborn risks. Exposure late in pregnancy can be associated with temporary neonatal adaptation symptoms, and the newborn may need observation when clinically appropriate. Do not stop escitalopram suddenly if you are pregnant. Speak to your doctor first.

Escitalopram and Breastfeeding

Escitalopram passes into breast milk in small amounts. It can be used during breastfeeding in some situations under medical supervision. Watch the baby for unusual sleepiness, poor feeding, irritability or other concerning symptoms and tell the doctor. The choice depends on the mother’s condition and the baby’s circumstances, so discuss it with your doctor rather than stopping on your own.

Escitalopram Brands in India

Commonly listed brands in India include Nexito, Stalopram and Rexipra. Availability varies by location and may change over time.

Escitalopram Price in India

Escitalopram 10 mg tablets may cost approximately ₹70-₹150 depending on the brand and pack size. Prices may vary by brand, strength, pack size, pharmacy, location and discounts.

How HealthPil Can Help

HealthPil provides access to qualified doctors who can discuss treatment options, side effects and medication concerns.

Do not start, stop or change escitalopram on your own. You can consult a doctor online with HealthPil to discuss whether it is right for you.