Disclaimer: Human Health is not recommending any specific medical treatment for any particular symptom, nor providing any other medical advice. Always seek the advice of your doctor regarding any medical concern.

Indications

Escitalopram is a medication approved by the FDA to treat major depressive disorder (depression) and generalized anxiety disorder (anxiety).

It is sometimes used to treat other conditions, including:

• Obsessive-compulsive disorder (OCD)
• Social anxiety disorder
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Pre-menstrual dysphoric disorder (PMDD)

Brand names

Escitalopram is available under a variety of different brand names, including:

• Lexapro
• Cipralex
• Cilopam
• Escicor
• Esipram
• Lexam
• Loxalate

Formats

Escitalopram is available as an oral solution and as oral tablets.

Approval

Escitalopram was first approved for use as a medical treatment in 2002.

Drug class

Escitalopram is an antidepressant. It is a particular type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI).

Mechanism of action

Escitalopram works by blocking the action of proteins in the brain called serotonin transporters. When serotonin transporters are deactivated, the amount of available serotonin in the brain increases.

Serotonin is a hormone that is involved in regulating processes such as mood, behavior, appetite, perception, fear and stress. Changing the level of serotonin in the brain can therefore have an effect on conditions including depression and anxiety.

What’s the difference between escitalopram and other antidepressants?

When determining an appropriate treatment plan, clinicians will consider a variety of factors relevant to the patient, including things like their age, the specific condition(s) they have, other treatments they are already on, and the side effects of the treatment.

Compared to other SSRIs, including sertraline, fluoxetine, and citalopram, escitalopram may be structurally different, may be effective at a different dose, and may be metabolized and excreted differently by the body.

Escitalopram is indicated for generalized anxiety disorder, which some other SSRIs, including sertraline and fluoxetine, are not approved to treat.

Escitalopram is one of only a few antidepressants approved for use in pediatric patients with major depressive disorder, with the other being fluoxetine.

For some conditions, escitalopram may be a more effective treatment than another SSRI called citalopram.

Unlike some other SSRIs, escitalopram may be less likely to affect certain metabolic pathways in the body, which means that it may be less likely to impact the action of other drugs in the body.

Compared to some other classes of antidepressants, SSRIs like escitalopram may have fewer or less severe side effects.

Side effects

It is important to note that there may be increased risk for suicidal thinking and behavior in children, adolescents and young adults taking antidepressants for depression or other psychiatric disorders.

Escitalopram may also make the heart beat faster or irregularly.

The most common side effects (>5% of patients) of escitalopram include:

• Insomnia
• Fatigue
• Sleepiness
• Sexual dysfunction
• Decreased libido
• Nausea
• Increased sweating

Special instructions

The safety and action of escitalopram has not been studied in children under 7 with anxiety, or children under 12 with depression.

Patients taking another type of antidepressant called monoamine oxidase inhibitors (MOAIs) should not take escitalopram.

Patients taking an antipsychotic drug called pimozide should not take escitalopram.

Resources

1. Bamalan OA, Moore MJ, Al Khalili Y. Physiology, Serotonin. [Updated 2023 Jul 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545168/
2. Feighner JP. Mechanism of action of antidepressant medications. J Clin Psychiatry. 1999;60 Suppl 4:4-11; discussion 12-3. PMID: 10086478.
3. Azorin JM, Llorca PM, Despiegel N, Verpillat P. Escitalopram is more effective than citalopram for the treatment of severe major depressive disorder. Encephale. 2004 Mar-Apr;30(2):158-66. French. doi: 10.1016/s0013-7006(04)95427-9. PMID: 15107719.
4. Marken PA, Munro JS. Selecting a Selective Serotonin Reuptake Inhibitor: Clinically Important Distinguishing Features. Prim Care Companion J Clin Psychiatry. 2000 Dec;2(6):205-210. doi: 10.4088/pcc.v02n0602. PMID: 15014630; PMCID: PMC181142.
5. BARRY H. GUZE, ELISA A. MORENO, JOSEPH K. PERLOFF, CHAPTER 13 - Psychiatric and Psychosocial Disorders in Congenital Heart Disease, Congenital Heart Disease in Adults (Third Edition), W.B. Saunders, 2009, Pages 290-306, ISBN 9781416058946,https://doi.org/10.1016/B978-1-4160-5894-6.50017-4.
6. Landy K, Rosani A, Estevez R. Escitalopram. [Updated 2023 Nov 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557734/
7. Lexapro (escitalopram oxalate) US Prescribing Information. 2023. Available from: https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=021323

‍