Escitalopram: therapeutic uses and side effects
Selective serotonin reuptake inhibitors are the most commonly 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.
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What is escitalopram?
Escitalopram is an antidepressant drug from the class of selective serotonin reuptake inhibitors (SSRIs). Other commonly used drugs in this group are sertraline, paroxetine, fluoxetine, fluvoxamine and citalopram, a history of escitalopram very similar to this one .
This psychopharmaceutical was created between 1997 and 2001 by the pharmaceutical companies H. Lundbeck A / S and Forest Laboratories, which had previous experience in the production of citalopram. At present it is one of the most used SSRIs.
It is marketed under different names in many countries of the world. Some of the best known are Cipralex, Lexapro, Esertia, Meridian, Ipran and Heipram ; A large number of brands include the term "Escitalopram" in the name of the product.
Unlike other SSRIs, escitalopram has a highly selective effect on serotonin receptors; This means that its interaction with other neurotransmitter receptors is poor. For this reason, some authors attribute it a higher efficacy than other SSRIs in the treatment of severe depression.
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Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are the group of antidepressants that is prescribed more frequently. Its effectiveness in treating symptoms of depression and anxiety It is attributed to its agonism of different monoamines (a type of neurotransmitter very relevant): serotonin, noradrenaline and dopamine.
The mechanism of action of SSRIs is not known exactly, although its effects are known to be associated with the blockade of serotonin reuptake, as its name suggests. These drugs increase the availability of serotonin in the synaptic space by limiting its reabsorption by postsynaptic receptors.
Drugs in this class are mainly 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 for?
Like other SSRIs, escitalopram has been shown to be effective in treating multiple symptoms related to anxiety and depression, although not in all countries its use for the same disorders is approved.
Let's see what they are The most common therapeutic uses of escitalopram .
1. Major depressive disorder
Various scientific investigations have shown the effectiveness of escitalopram in the treatment of major depressive disorder. Some of the additional uses of this drug are associated with alterations biologically related to depression , in particular generalized anxiety disorder, obsessive-compulsive disorder and bulimia nervosa.
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2. Generalized anxiety disorder
The therapeutic effects of escitalopram in cases of generalized anxiety disorder are significant and rapid; Clear improvements are detected in the condition of most patients approximately two months after starting treatment.
3. Panic disorder
Panic disorder is characterized by emergence of anguish crisis , during which symptoms such as tachycardia, breathing difficulties and fear of dying arise. It may or may not be accompanied by agoraphobia.
4. Social phobia
In social phobia they appear anxiety and avoidance symptoms 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 frequently used for the treatment of obsessive-compulsive disorder or OCD, which is diagnosed when obsessive thoughts are present that provoke anxiety and behavioral rituals that aim to reduce discomfort.
Side effects of escitalopram
The most common side effects of escitalopram use are the headache, nausea, diarrhea and insomnia . Other less common ones include the appearance of anxiety, dizziness, fatigue, drowsiness, sweating, dry mouth, constipation, burning and gas from the stomach.
It is also relatively common for them to develop Sexual dysfunctions as a result of treatments with escitalopram and other SSRIs , especially desire decrease, genital anesthesia, arousal disorders, ejaculatory delay and anorgasmia.
Among the serious adverse reactions that may occur with the taking of escitalopram, although they are rare, include seizures, breathing difficulties, changes in heart rhythm and inflammation of the face, hands and ankles.
Precautions and contraindications
Special caution must be exercised when prescribing escitalopram if the person presents heart, respiratory, liver or kidney disorders relevant, as well as if you have suffered manic episodes or epileptic seizures.
In children and adolescents, hostile behaviors and suicide attempts associated with escitalopram appear with a higher frequency than that detected in adults; However, it is also possible for people who are of legal age to produce these reactions, which are usually detectable by monitoring the effects of treatment during the first weeks.
Given that there is some risk of pharmacological tolerance and dependence, the abrupt cessation of consumption may cause the onset of serotonin syndrome characteristic of SSRIs. In this case, the most common symptoms are the appearance of depressive reactions, irritability, sensations of dizziness and akathisia.
Its potential for negative interaction with other substances is low compared to that of other SSRIs, particularly paroxetine. It is advisable to avoid taking escitalopram and antidepressants from the class of monoamine oxidase inhibitors (MAOIs) because of the increased risk of developing serotonin syndrome.
Bibliographic references:
- General Council of Official Associations of Pharmacists. (2009). Mood disorders: depression and anxiety. Strategic plan for the development of pharmaceutical care'09. [Internet].
- Morán I, Baldirà J, Morocco L, Nogué S. (2011). Clinical toxicology Madrid: Legal Dissemination and Current Issues S.A.
- Spanish Agency of Medicines and Health Products. Use of antidepressant medications in Spain during the period (2015). 2000-2013. Drug Utilization Report [Internet] 2015 [Access: August 2, 2018] Available at: //www.aemps.gob.es/medicamentosUsoHumano/observatorio/docs/antidepresivos2000-2013.pdf
