Escitalopram (Lexapro) Flashcards

1
Q

Brand

A

Lexapro

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2
Q

Class, MOA

A

SSRI (1A)

*no known secondary properties for escitalopram

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3
Q

Onset

A

2-4 weeks

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4
Q

S/Es, Augment

A

Same as sertraline

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5
Q

Dose

A
  • 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
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6
Q

OD

A

Same as citalopram, but rarer

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7
Q

Taper

A

50% for 3 days, 50% for next 3 days, stop

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8
Q

Half life

A
  • 27-32 hours

* Achieves steady state plasma conc in 1 week

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9
Q

CYP action

A

None

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10
Q

C/I with

A
  • MAOIs
  • Pimozide

Allergy to citalopram and escitalopram

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11
Q

Special populations

A
  • Use 10 mg in hepatic pts and in elderly

* Can use in kids above 12 years

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12
Q

Advantages

A
  • Patients taking other meds, as it as fewer drug interactions and no CYP action
  • Patients needing faster onset of action
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13
Q

Disadvantages

A

More expensive than citalopram

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14
Q

Of note

A
  • 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.

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