Escitalopram (Lexapro) Flashcards
Brand
Lexapro
Class, MOA
SSRI (1A)
*no known secondary properties for escitalopram
Onset
2-4 weeks
S/Es, Augment
Same as sertraline
Dose
- 10-20 mg once daily
- Start at 10, inc to 20 if needed
- 10 mg of escitalopram is comparable to 40 mg of citalopram with fewer side effects
- Rarely 30-40 mg needed
OD
Same as citalopram, but rarer
Taper
50% for 3 days, 50% for next 3 days, stop
Half life
- 27-32 hours
* Achieves steady state plasma conc in 1 week
CYP action
None
C/I with
- MAOIs
- Pimozide
Allergy to citalopram and escitalopram
Special populations
- Use 10 mg in hepatic pts and in elderly
* Can use in kids above 12 years
Advantages
- Patients taking other meds, as it as fewer drug interactions and no CYP action
- Patients needing faster onset of action
Disadvantages
More expensive than citalopram
Of note
- One of the best tolerated antidepressants
- May have less sexual S/Es than other SSRIs
- Better tolerated than Citalopram
- No CYP action, so commonly used with augmenting agents as no interactions.
*Citalopram has both R and S components - R interferes with binding of S at serotonin transporters
Escitalopram has only S and no R component, so may be twice as potent as citalopram.
So 10 mg escitalopram is efficacious as 40 mg citalopram, and also has faster onset and less S/Es than citalopram.