Lexapro - Comprehensive Usage Guide: instructions, indications, composition, side effects
Composition
- Active Ingredient: Escitalopram oxalate
- Excipients: May include microcrystalline cellulose, colloidal silicon dioxide, croscarmellose sodium, magnesium stearate, and other inactive ingredients depending on the formulation.
Official Forms
- Tablets: Available in various strengths, including 5 mg, 10 mg, and 20 mg tablets.
Pharmacological Group
Lexapro belongs to the pharmacological group of selective serotonin reuptake inhibitors (SSRIs) (ATC code: N06AB10).
Pharmacological Properties
- Pharmacodynamics: Escitalopram exerts its antidepressant effects by selectively inhibiting the reuptake of serotonin (5-HT) in the synaptic cleft, thereby potentiating serotonergic neurotransmission in the central nervous system (CNS). It is believed that enhancement of serotonergic activity contributes to the alleviation of depressive symptoms.
- Pharmacokinetics: Escitalopram is well-absorbed after oral administration, with peak plasma concentrations achieved within 4 to 5 hours. It undergoes hepatic metabolism primarily via the cytochrome P450 enzyme system (CYP2C19 and CYP3A4) and is excreted mainly in the urine.
Indications
Lexapro is indicated for the treatment of:
- Major depressive disorder (MDD)
- Generalized anxiety disorder (GAD)
- Panic disorder (PD)
- Obsessive-compulsive disorder (OCD)
- Social anxiety disorder (SAD)
Contraindications
Lexapro is contraindicated in individuals with:
- Hypersensitivity to escitalopram or any component of the formulation
- Concomitant use of monoamine oxidase inhibitors (MAOIs) or within 14 days of discontinuing MAOI therapy
- Known congenital long QT syndrome or a history of QT prolongation
- Severe hepatic impairment
Interactions
Escitalopram may interact with other medications, including:
- MAOIs, SSRIs, SNRIs, tricyclic antidepressants, and other serotonergic drugs, increasing the risk of serotonin syndrome
- Drugs that inhibit CYP2C19 or CYP3A4 enzymes, potentially increasing escitalopram levels and toxicity
- NSAIDs, aspirin, and other drugs that affect platelet function, increasing the risk of bleeding
Specifics of Use
- Lexapro should be taken orally once daily, with or without food, as directed by a healthcare provider.
- The initial dosage for MDD and GAD is 10 mg/day, which may be increased to a maximum of 20 mg/day after at least one week of treatment.
- For PD, OCD, and SAD, the recommended starting dose is 5 mg/day, with gradual titration to a maximum of 20 mg/day as needed.
Pregnancy and Breastfeeding
- Lexapro should be used with caution during pregnancy, especially during the third trimester, and only if the potential benefits outweigh the potential risks to the fetus.
- Escitalopram is excreted in breast milk, and breastfeeding is not recommended during Lexapro treatment due to the potential risk to the infant.
Dosage and Administration
- Dosage adjustments may be necessary in patients with hepatic impairment or renal impairment to prevent drug accumulation and minimize the risk of adverse effects.
- Elderly patients may require lower initial doses and slower titration due to age-related changes in drug metabolism.
Overdose
In case of overdose, supportive measures should be initiated, and medical attention should be sought immediately. Symptoms of escitalopram overdose may include nausea, vomiting, tremor, drowsiness, dizziness, and serotonin syndrome.
Side Effects
Common side effects of Lexapro may include:
- Nausea
- Headache
- Insomnia
- Somnolence
- Diarrhea
- Sexual dysfunction
Storage and Shelf Life
Lexapro tablets should be stored at controlled room temperature (20-25°C) in a dry place, protected from light and moisture. The expiration date should be checked before use.
These comprehensive instructions provide essential information on the composition, pharmacological properties, indications, contraindications, interactions, administration, side effects, and storage of Lexapro, aiding healthcare professionals and patients in safe and effective medication use. Always consult a healthcare provider for personalized medical advice.