Feliz S 10/Feliz S 20

Acute & maintenance treatment of major depressive disorder in adults & adolescents 12-17 yr. Management of generalized anxiety disorder, obsessive-compulsive disorder, panic disorder w/ or w/o agoraphobia, social phobia & PTSD.

Major depressive disorder Adult Initially 10 mg once daily, may be increased to 20 mg after a min of 1 wk. Adolescent 10 mg once daily, may be increased to 20 mg after a min of 3 wk. General anxiety disorder Initially 10 mg once daily, may be increased to 20 mg after a min of 1 wk. Panic disorder w/ or w/o agoraphobia Initially 5 mg for the 1st wk before increasing to 10 mg daily, may be increased up to max 20 mg daily. Switching patient to or from a MAOI At least 14 days should elapse between discontinuation of a MAOI & inhibition of escitalopram before starting a MAOI. Elderly & patient w/ hepatic impairment Initially 5 mg daily for the 1st 2 wk, may be increased to 10 mg daily.

May be taken with or without food: Take in the morning or evening.

Hypersensitivity to escitalopram or citalopram. Concomitant use w/ MAOIs & pimozide.

W/draw gradually to reduce risk of w/drawal symptoms. Risk of serotonin syndrome, particularly w/ concomitant use of other serotonergic drugs or drugs that impair serotonin metabolism. Monitor patients for emergence of serotonin syndrome. Possibility of suicide attempts may persist until significant remission occurs; high risk patients w/ major depressive disorder should be closely supervised. Reports of hyponatremia or SIADH; activation of mania/hypomania. Caution in patients w/ history of seizure disorder; diseases or conditions that produce altered metabolism or hemodynamic responses; severe renal impairment. May trigger angle closure glaucoma in patient w/ anatomically narrow angles who does not have patent iridectomy. Concomitant use w/ NSAIDs, aspirin or other drugs that affect coagulation. Interference w/ cognitive & motor performance. Should only be used during pregnancy & lactation if potential benefit justifies potential risk. Safety & effectiveness have not been established in ped patients <12 yr w/ major depressive disorder & <18 yr w/ generalized anxiety disorder.

Headache; nausea. Decreased/increased appetite, increased wt; anxiety, restlessness, abnormal dreams, decreased libido, anorgasmia (female); insomnia, somnolence, dizziness, paraesthesia, tremor; sinusitis, yawning; diarrhoea, constipation, vomiting, dry mouth; increased sweating; arthralgia, myalgia; ejaculation disorder & impotence (male); fatigue, pyrexia.

Potential interaction w/ other CNS drugs. Not recommended w/ alcohol. Enhanced serotonergic effects w/ lithium. Rare reports of weakness, hyperreflexia & incoordination w/ sumatriptan. Decrease C_max & AUC of ketoconazole. Increased plasma conc w/ CYP2C19 inhibitors (eg, omeprazole, esomeprazole, fluvoxamine, lansoprazole, ticlopidine) or cimetidine. Caution when co-administered w/ CYP2D6 substrates w/ narrow therapeutic index eg, flecainide, propafenone, metoprolol (when used in cardiac failure), or some CNS-acting medicinal products that are mainly metabolized by CYP2D6 eg, antidepressants (eg, desipramine, clomipramine & nortriptyline) or antipsychotics (eg, risperidone, thioridazine, haloperidol). Increase plasma levels of desipramine. Increase C_max & AUC of metoprolol. Potentiated risk of bleeding w/ NSAIDs & aspirin. Altered anticoagulant effects, including increased risk of bleeding w/ warfarin.

Antidepressants

N06AB10 - escitalopram ; Belongs to the class of selective serotonin reuptake inhibitors. Used in the management of depression.

Rx