Saturday, April 13, 2019

Escitalopram for mood and anxiety disorders

Escitalopram belongs to a group of medicines called SSRI antidepressants. It is prescribed for the treatment of some mood and anxiety disorders. These are depression, panic disorder, social anxiety disorder, generalised anxiety disorder and obsessive-compulsive disorder.

Both depression and anxiety disorders can develop for no apparent reason, but they can also be triggered by a life event such as a relationship problem, a work-related problem, bereavement, or illness. Whatever the cause of the problem, when the symptoms are severe enough, they can interfere with normal day-to-day activities. When this happens, taking a medicine such as escitalopram can help to ease the symptoms and restore normal daily routines. Escitalopram works by regulating the level of a certain chemical in your brain, called serotonin.

Before taking escitalopram
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking escitalopram it is important that your doctor knows:

If you are pregnant, trying for a baby or breast-feeding.
If you have any problems with the way your liver works, or any problems with the way your kidneys work.
If you have a heart condition or heart rhythm disorder.
If you have epilepsy.
If you have sugar diabetes.
If you have increased eye pressure (called glaucoma).
If you have ever had a bleeding disorder, or a stomach or duodenal ulcer.
If you have ever had abnormally 'high' moods, called mania.
If you are being treated with electroconvulsive therapy (ECT).
If you have ever had an allergic reaction to a medicine.
If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to take escitalopram
Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about escitalopram and will provide you with a full list of the side-effects which you may experience from taking it.
Take escitalopram exactly as your doctor tells you to. It is prescribed as a once-daily dose. You can generally take it at a time to suit you, but try to take your doses at the same time of day, each day. You can take escitalopram either with or without food.
There are several strengths of tablet available; 5 mg, 10 mg and 20 mg. Your doctor will tell you which strength is right for you. This information will also be on the label of the pack you have been supplied with.
If you have been given escitalopram oral drops, your doctor will tell you how many drops to take each day. Count the correct number of drops into a drink of water, orange juice or apple juice. Stir the liquid briefly, and then drink it straightaway.
If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, leave out the forgotten dose from the previous day and take the dose that is due as normal. Do not take two doses at the same time to make up for a missed dose.
Getting the most from your treatment
Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress.
You may feel that escitalopram is not helping you straightaway. This is because it can take a week or two before the effect begins to build up, and a few weeks more before you feel the full benefit. It is important that you continue to take escitalopram, even if it takes a little while for your condition to improve.
If you develop any depressing or suicidal thoughts or ideas, you should let your doctor know about it as soon as possible. These thoughts can be associated with your condition and also with your treatment (particularly when the treatment is first started). It is very important that you tell your doctor about any distressing thoughts or ideas.
There are several types of antidepressants and they differ in their possible side-effects. If you find that escitalopram does not suit you then let your doctor know, as another may be found that will.
If you drink alcohol, ask your doctor for advice about drinking while you are on escitalopram. Drinking alcohol could increase the risk of unwanted effects such as feeling sleepy.
If you buy any medicines, check with a pharmacist that they are suitable to take with escitalopram. This is because several medicines which are available from general retail outlets can increase the risk of unwanted effects. In particular, do not take the herbal remedy called St John's wort, and please ask for advice before buying any anti-inflammatory painkillers such as ibuprofen or aspirin.
Keep taking escitalopram until your doctor tells you otherwise. Your treatment is likely to last for several months - this is normal and helps to prevent your symptoms from recurring. Stopping suddenly can cause symptoms such as headache, sickness, anxiety, dizziness, shakiness and sleeping problems, so when it is time for your treatment to finish, your doctor will reduce your dose gradually over a week or two.
Can escitalopram cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with escitalopram. The best place to find a full list of the side-effects which can be associated with your medicine, is from the manufacturer's printed information leaflet supplied with the medicine. Alternatively, you can find an example of a manufacturer's information leaflet in the reference section below. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

Very common escitalopram side-effects (these affect more than 1 in 10 people) What can I do if I experience this?
Headache Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If the headache continues, speak with your doctor
Feeling sick Stick to simple meals - avoid fatty or spicy food
Common escitalopram side-effects (these affect less than 1 in 10 people)
What can I do if I experience this?
Being sick, tummy (abdominal) pain, diarrhoea, indigestion Stick to simple meals - avoid fatty or spicy food
Feeling dizzy, or sleepy Do not drive and do not use tools or machines while affected
Constipation Try to eat a well-balanced diet containing plenty of fibre, and drink several glasses of water each day
Dry mouth Try chewing sugar-free gum, or sucking sugar-free sweets
Unusual dreams, sleeping problems, tingling feelings, yawning, feeling hot, sweating, changes in appetite or weight, feeling restless or shaky If any becomes troublesome, speak with your doctor
If you experience any other symptoms which you think may be due to escitalopram, please speak with your doctor or pharmacist for further advice.

How to store escitalopram
Keep all medicines out of the reach and sight of children.
Store in a cool, dry place, away from direct heat and light.
You can use escitalopram drops for eight weeks after first opening the bottle. After this time, make sure you have a fresh supply to use.
Important information about all medicines
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

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Manufacturer's PIL, Cipralex® 5, 10, and 20 mg Film-coated Tablets; Lundbeck Limited, The electronic Medicines Compendium. Dated September 2013.

Manufacturer's PIL, Cipralex® oral drops solution, 20 mg/ml; Lundbeck Limited, The electronic Medicines Compendium. Dated September 2013.

British National Formulary; 72nd Edition (Sep 2016) British Medical Association and Royal Pharmaceutical Society of Great Britain, London

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