Escitalopram

This page contains recent news articles, when available, and an overview of Escitalopram but does not offer medical advice. You should contact your physician with regard to any health issues or concerns.


Overview:

Escitalopram
(when available)

Pharmacology and use:
Escitalopram is one of a class of antidepressants known as selective serotonin reuptake inhibitors (SSRIs). It is used to treat the depression associated with mood disorders. It is also used on occassion in the treatment of body dysmorphic disorder and anxiety. The antidepressant, antiobsessive-compulsive, and antibulimic actions of escitalopram are presumed to be linked to its inhibition of CNS neuronal uptake of serotonin. In vitro studies show that escitalopram is a potent and selective inhibitor of neuronal serotonin reuptake and has only very weak effects on norepinephrine and dopamine neuronal reuptake. Escitalopram has no significant affinity for adrenergic (alpha1, alpha2, beta), cholinergic, GABA, dopaminergic, histaminergic, serotonergic (5HT1A, 5HT1B, 5HT2), or benzodiazepine receptors; antagonism of such receptors has been hypothesized to be associated with various anticholinergic, sedative, and cardiovascular effects for other psychotropic drugs. The chronic administration of escitalopram was found to downregulate brain norepinephrine receptors, as has been observed with other drugs effective in the treatment of major depressive disorder. Escitalopram does not inhibit monoamine oxidase. For the treatment of major depressive disorder and Generalized Anxiety Disorder (GAD).

Mechanism Of Action:
The antidepressant, antiobsessive-compulsive, and antibulimic actions of escitalopram are presumed to be linked to its inhibition of CNS neuronal uptake of serotonin. Escitalopram blocks the reuptake of serotonin at the serotonin reuptake pump of the neuronal membrane, enhancing the actions of serotonin on 5HT1A autoreceptors. SSRIs bind with significantly less affinity to histamine, acetylcholine, and norepinephrine receptors than tricyclic antidepressant drugs.

News Articles on Escitalopram

How Big Pharma Distorts Science to Get FDA Approval for Dangerous ...  -  20 Apr 2009
Last May a pro Lexapro article, "Escitalopram and Problem-Solving Therapy for Prevention of Poststroke Depression," ran in JAMA, the Journal of the American AlterNet

Forest Under Fire  -  ‎Apr 8, 2009‎
Forest was also accused of using “illegal� inducements to physicians to get them to prescribe citalopram and escitalopram. “By knowingly and actively Psychiatric Times

Rationale, design and methodology of a double-blind, randomized ...  -  ‎Apr 7, 2009‎
Methods: Two hundred forty non-depressed patients with acute coronary syndrome are randomized to treatment with either escitalopram or placebo for 1 year. 7thSpace Interactive (press release)

Treating the human condition  -  ‎Apr 14, 2009‎
When one Googles "Escitalopram" (the generic name of Cypralex, which is marketed in the US as Lexapro), over 1 million hits come up. Ha'aretz

Cognitive Behavior Therapy Eases Anxiety for Older People  -  ‎Apr 7, 2009‎
Another study, however, confirmed that Lexapro (escitalopram) was an effective anxiety treatment. This study, published in the Jan. Forbes

Groundbreaking study into depression  -  ‎Apr 16, 2009‎
...brain and cognitive markers that can predict specific responses to a range of antidepressants including sertraline, escitalopram and venlafaxine. The Virtual Medical Centre

JAMA editors embroiled in brouhaha over treatment of critic  -  ‎Apr 1, 2009‎
...in the May 2008 issue of JAMA touting the supposed benefits of the antidepressant Lexapro (escitalopram) in warding off the blues in stroke victims. Scientific American

Prevention of first-episode depression: progress and potential  -  ‎Mar 31, 2009‎
5 Escitalopram-treated patients (n=59) (10 mg/day, age <65 and 5 mg/day, age 65) were significantly less likely to develop depression during 1 year of British Journal of Psychiatry

The National Pharmaceuticals Strategy: Rest in peace, revive or renew?  -  ‎Apr 13, 2009‎
While the Common Drug Review recommended that the provinces not provide coverage for escitalopram (Cipralex) in November 2008, Ontario's Committee to CMAJ

룬드벡, ì•„ì?¼ëžœë“œ 엘란사 ì?¸ìˆ˜ì„¤â€¦ì„±ì‚¬ëŠ” 미지수  -  ‎Mar 31, 2009‎
...다른 거래ë?„ 다ê°?ì ?으로 진행하고 있다. ê·¸ ì?´ìœ ëŠ” 2012ë…„ 거대 품목ì?¸ 렉사프로(Lexapro: escitalopram)ì?˜ 특허 만료로 ë°œìƒ?ë?  매출 ê°?소를 보충하기 위해서다. 메디포뉴스

Advancell y Nobera unen su I+D en síndrome de mano-pie  -  ‎Mar 29, 2009‎
Forest Laboratories ha recibido el visto bueno de la agencia estadounidense FDA para la ampliación de las indicaciones de Lexapro (escitalopram) para el Correo Farmacéutico

혈압강하제 등 ì?˜ì•½í’ˆ 120ê°œ 15ì?¼ë¶€í„° ì‹ ê·œ 보험등재  -  ‎Apr 5, 2009‎
...ì?´ë°–ì—? 종근당ì?˜ ‘ì—?스시탈정(escitalopram oxalate)’ 등 정신신경용제 24개와 중외제약ì?˜ ‘중외신약í?´ë¦¬ì†Œë¥´ë² ì?´íЏ80ì ?안액(polysorbate80)’ 등 안과용제 1ê°œ, 헬스코리아뉴스

Rischio di emorragia gastroenterica con gli SSRI e SRNI  -  ‎Mar 28, 2009‎
95% CI 1,5-5,7) e sertralina (OR 2,3; IC 95%1,0-5,1) riportavano il rischio più alto, seguiti da citalopram o escitalopram (OR: 2.0; IC 95%: 1,2-3,2). Pillole.org

تتعرق راحات اليدين بمجرد الشعور بالخوÙ?ØŒ Ù?ما تشخيص هذه الحالة؟  -  ‎Apr 7, 2009‎
المثالي، هنالك أدوية مضادة لقلق المخاوÙ? Ø£Ù?ضلها عقار يعرÙ? تجاريًا باسم (سبرالكس Cipralex) ويعرÙ? علميًا باسم (استالوبرام Escitalopram)ØŒ أنا لستÙ? متأكدًا الشبكة الإسلامية

House of Lords Upholds Validity of Lundbeck's Escitalopram Patent  -  ‎Mar 17, 2009‎
In a unanimous decision, the Appellate Committee of the UK House of Lords has upheld the validity of Lundbeck's patent for escitalopram. (Escitalopram Linex Legal

Treatment of Anxiety in Older People May Benefit Overall Health ...  -  ‎Mar 17, 2009‎
...(1) Their study randomised 85 patients to 12 weeks of escitalopram 10 to 20 mg/day and 92 patients to placebo. All patients were at least 60 years of age DG News

Incomplete Financial Disclosure in a Study of Escitalopram and ...  -  ‎Mar 10, 2009‎
To the Editor: We would like to report an incomplete financial disclosure in our study of escitalopram and problem-solving therapy for prevention of Journal of American Medical Association (subscription)

Aurobindo Pharma's Escitalopram will be a big mover ... when it ...  -  ‎Mar 5, 2009‎
Due to such a high volume of the brand product, Aurobindo's tentative approval on Lexapro's generic Escitalopram will be a great opportunity - primarily if Gerson Lehrman Group

Forest Labs' Lexapro Flap Over JAMA Article Will Likely Be ...  -  ‎Mar 16, 2009‎
By Jim Edwards | March 16th, 2009 @ 11:35 am An editor of the Journal of the American Medical Association called a university professor “a nobody and a BNET

Aurobindo Pharma receives tentative approval for Escitalopram  -  ‎Mar 3, 2009‎
Escitalopram Oxalate has a market size of approximately US$ 2.6 Billion for the twelve months ending September 2008 according to IMS. India Infoline.com

Differential efficacy of escitalopram and nortriptyline on ...  -  ‎Feb 27, 2009‎
To test the hypothesis that escitalopram and nortriptyline differ in their effects on observed mood, cognitive and neurovegetative symptoms of depression. British Journal of Psychiatry

Aurobindo Pharma gets USFDA nod for anti-depressant drug  -  ‎Mar 4, 2009‎
Escitalopram Oxalate tablets are the generic version of Forest Laboratories' Lexapro used in treating patients suffering from depression and mood disorders, Trading Markets (press release)

Anxiety in the Elderly -- Research Summary  -  ‎Mar 16, 2009‎
They found after 12 weeks of treatment, 68 percent of patients taking escitalopram (Lexapro) had improved, and only 51 percent of those taking the placebo Ivanhoe

Aurobindo settled 3% up on bourses after deal with Pfizer  -  ‎Mar 4, 2009‎
Meanwhile, Hyderabad-based company has also received tentative approval from the US drug regulator for anti-depressant tablets Escitalopram Oxalate. Economic Times

Annual report 2008 - Lundbeck meets all of its financial forecasts ...  -  ‎Mar 5, 2009‎
As a result of the decisions, generic escitalopram cannot be marketed in Canada before the patent for escitalopram expires. The composition-of-matter patent Lifescience-online

Generalized tonic-clonic seizure after a taser shot to the head  -  ‎Mar 16, 2009‎
Treatment trials have included amitriptyline 50 mg nightly, topiramate 25 mg nightly, escitalopram 10 mg nightly, almotriptan 12.5 mg as needed and CMAJ

How do you fight depression after injury, job loss?  -  ‎Mar 10, 2009‎
...citalopram or escitalopram) many studies suggest that antidepressants that affect both serotonin and the related neurotransmitter norepinephrine have CNN

'Simple Product Claims' Escape Biogen  -  ‎Mar 6, 2009‎
This concludes the final installment in the story of Lundbeck's patent for escitalopram - a single enantiomer drug for the treatment of depression - and Linex Legal

Closing Bell  -  ‎Mar 4, 2009‎
2:15 pm: Aurobindo Pharma Ltd has received tentative approval for Escitalopram Oxalate Tablets of 5mg, 10 mg and 20 mg strength from the US Food & Drug Economic Times

MonoSol Rx Achieves Milestones for Additional $2.5 Million Private ...  -  ‎Mar 12, 2009‎
Completed pilot product development for a thin film formulation of escitalopram oxalate, a selective serotonin reuptake inhibitor (SSRI) marketed under the PR Newswire (press release)

Pharma | Aurobindo gets USFDA nod for antidepressant  -  ‎Mar 4, 2009‎
Ltd said it has received tentative approval from the US Food and Drug Administration (FDA) to sell antidepressant escitalopram oxalate in tablet form. Livemint

Highlights of this issue  -  ‎Feb 27, 2009‎
They found that the treatment effects of escitalopram and nortriptyline could be differentiated using dimensional measures of symptoms, with greater British Journal of Psychiatry

Analyses - Almirall: Citi reste à conserver  -  ‎Mar 11, 2009‎
Some downside risk is possible from early termination of data protection on escitalopram (although Lundbeck recently won a legal battle in the UK on this Bolsamania.fr

Ranbaxy in Trouble  -  ‎Feb 26, 2009‎
...the Lundbeck people checked a patent and an article (published by OPRD) about escitalopram synthesis, and found that the chemistry published by Dr Corante

Forest Labs in trouble for marketing Celexa to children, kickbacks  -  ‎Feb 25, 2009‎
Lexapro is a closely related chemical, escitalopram, and the mechanisms of action are assumed to be the same. Researchers and doctors became increasingly Raw Story

Patients' Depression Treatment Preferences and Initiation ...  -  ‎Feb 27, 2009‎
Participants received either 20 weeks of escitalopram, with monitoring by a care manager, or 12 weekly sessions of interpersonal psychotherapy followed by Psychiatric Services (subscription)

Sensex recovers from lows  -  ‎Mar 3, 2009‎
Shares of Aurobindo Pharma have surge by over 2.5% to Rs160 after the company announced that it received tentative approval for Escitalopram Oxalate Tablets India Infoline.com

Listless markets ends flat  -  ‎Mar 4, 2009‎
Shares of Aurobindo Pharma surge by over 3% to Rs160 after the company announced that it received tentative approval for Escitalopram Oxalate Tablets 5mg, India Infoline.com

ضيق الصدر وسرعة دقات القلب ... هل هي أعراض عضوية أم Ù†Ù?سية؟  -  ‎Feb 25, 2009‎
هذا العلاج الدوائي، وهناك عقار يعرÙ? تجاريًا باسم (سبرالكس Cipralex) ويعرÙ? علميًا باسم (استالوبرام Escitalopram)ØŒ هو من الأدوية الÙ?عالة والممتازة، أرجو الشبكة الإسلامية

Brand Names/Synonyms:
Escitalopram is also known by the following brand names and/or synonymsEscitalopram; Escitalopram Oxalate; Escitalopram [Inn]; Lexapro

Drug Category:
Escitalopram is categorized under the following by the FDA: Antidepressive Agents, Second-Generation; Serotonin Uptake Inhibitors; ATC:N06AB10

Dosage Forms:
TABLET

Absorption:
The absolute bioavailability of citalopram is about 80% relative to an intravenous dose

Interactions:
-->Interactions for Escitalopram:

CNS Drugs - Given the primary CNS effects of escitalopram, caution should be used when it is taken in combination with other centrally acting drugs.

Alcohol - Although LEXAPRO did not potentiate the cognitive and motor effects of alcohol in a clinical trial, as with other psychotropic medications, the use of alcohol by patients taking LEXAPRO is not recommended. Monoamine Oxidase Inhibitors (MAOIs) - See Contraindications and Warnings.

Drugs That Interfere With Hemostasis (NSAIDs, Aspirin, Warfarin, etc.)

Serotonin release by platelets plays an important role in hemostasis. Epidemiological studies of the case-control and cohort design that have demonstrated an association between use of psychotropic drugs that interfere with serotonin reuptake and the occurrence of upper gastrointestinal bleeding have also shown that concurrent use of an NSAID or aspirin potentiated the risk of bleeding. Thus, patients should be cautioned about the use of such drugs concurrently with LEXAPRO.

Cimetidine - In subjects who had received 21 days of 40 mg/day racemic citalopram, combined administration of 400 mg/day cimetidine for 8 days resulted in an increase in citalopram AUC and Cmax of 43% and 39%, respectively. The clinical significance of these findings is unknown.

Digoxin - In subjects who had received 21 days of 40 mg/day racemic citalopram, combined administration of citalopram and digoxin (single dose of 1 mg) did not significantly affect the pharmacokinetics of either citalopram or digoxin.

Lithium - Coadministration of racemic citalopram (40 mg/day for 10 days) and lithium (30 mmol/day for 5 days) had no significant effect on the pharmacokinetics of citalopram or lithium. Nevertheless, plasma lithium levels should be monitored with appropriate adjustment to the lithium dose in accordance with standard clinical practice. Because lithium may enhance the serotonergic effects of escitalopram, caution should be exercised when LEXAPRO and lithium are coadministered.

Pimozide and Celexa - In a controlled study, a single dose of pimozide 2 mg co-administered with racemic citalopram 40 mg given once daily for 11 days was associated with a mean increase in QTc values of approximately 10 msec compared to pimozide given alone. Racemic citalopram did not alter the mean AUC or Cmax of pimozide. The mechanism of this pharmacodynamic interaction is not known.

Sumatriptan - There have been rare postmarketing reports describing patients with weakness, hyperreflexia, and incoordination following the use of a selective serotonin reuptake inhibitor (SSRI) and sumatriptan. If concomitant treatment with sumatriptan and an SSRI (e.g., fluoxetine, fluvoxamine, paroxetine, sertraline, citalopram, escitalopram) is clinically warranted, appropriate observation of the patient is advised.

Theophylline - Combined administration of racemic citalopram (40 mg/day for 21 days) and the CYP1A2 substrate theophylline (single dose of 300 mg) did not affect the pharmacokinetics of theophylline. The effect of theophylline on the pharmacokinetics of citalopram was not evaluated.

Warfarin - Administration of 40 mg/day racemic citalopram for 21 days did not affect the pharmacokinetics of warfarin, a CYP3A4 substrate. Prothrombin time was increased by 5%, the clinical significance of which is unknown.

Carbamazepine - Combined administration of racemic citalopram (40 mg/day for 14 days) and carbamazepine (titrated to 400 mg/day for 35 days) did not significantly affect the pharmacokinetics of carbamazepine, a CYP3A4 substrate. Although trough citalopram plasma levels were unaffected, given the enzyme-inducing properties of carbamazepine, the possibility that carbamazepine might increase the clearance of escitalopram should be considered if the two drugs are coadministered.

Triazolam - Combined administration of racemic citalopram (titrated to 40 mg/day for 28 days) and the CYP3A4 substrate triazolam (single dose of 0.25 mg) did not significantly affect the pharmacokinetics of either citalopram or triazolam.

Ketoconazole - Combined administration of racemic citalopram (40 mg) and ketoconazole (200 mg) decreased the Cmax and AUC of ketoconazole by 21% and 10%, respectively, and did not significantly affect the pharmacokinetics of citalopram.

Ritonavir - Combined administration of a single dose of ritonavir (600 mg), both a CYP3A4 substrate and a potent inhibitor of CYP3A4, and escitalopram (20 mg) did not affect the pharmacokinetics of either ritonavir or escitalopram.

CYP3A4 and -2C19 Inhibitors - In vitro studies indicated that CYP3A4 and -2C19 are the primary enzymes involved in the metabolism of escitalopram. However, coadministration of escitalopram (20 mg) and ritonavir (600 mg), a potent inhibitor of CYP3A4, did not significantly affect the pharmacokinetics of escitalopram. Because escitalopram is metabolized by multiple enzyme systems, inhibition of a single enzyme may not appreciably decrease escitalopram clearance.

Drugs Metabolized by Cytochrome P4502D6 - In vitro studies did not reveal an inhibitory effect of escitalopram on CYP2D6. In addition, steady state levels of racemic citalopram were not significantly different in poor metabolizers and extensive CYP2D6 metabolizers after multiple-dose administration of citalopram, suggesting that coadministration, with escitalopram, of a drug that inhibits CYP2D6, is unlikely to have clinically significant effects on escitalopram metabolism. However, there are limited in vivo data suggesting a modest CYP2D6 inhibitory effect for escitalopram, i.e., coadministration of escitalopram (20 mg/day for 21 days) with the tricyclic antidepressant desipramine (single dose of 50 mg), a substrate for CYP2D6, resulted in a 40% increase in Cmax and a 100% increase in AUC of desipramine. The clinical significance of this finding is unknown. Nevertheless, caution is indicated in the coadministration of escitalopram and drugs metabolized by CYP2D6.

Metoprolol - Administration of 20 mg/day LEXAPRO for 21 days in healthy volunteers resulted in a 50% increase in Cmax and 82% increase in AUC of the beta-adrenergic blocker metoprolol (given in a single dose of 100 mg). Increased metoprolol plasma levels have been associated with decreased cardioselectivity. Coadministration of LEXAPRO and metoprolol had no clinically significant effects on blood pressure or heart rate.

Electroconvulsive Therapy (ECT) - There are no clinical studies of the combined use of ECT and escitalopram.

Concomitant Administration with Racemic Citalopram

Citalopram - Since escitalopram is the active isomer of racemic citalopram (Celexa), the two agents should not be coadministered.





Chemical IUPAC Name:
1-(3-dimethylaminopropyl)-1-(4-fluorophenyl)-1,3-dihydroisobenzofuran-5-carbonitrile

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