Escitalopram

Sounds like 'ES-sigh-talo-pram'

Escitalopram is used to treat a number of mental health conditions including depression and anxiety. Find out how to take it safely and possible side effects.

What is escitalopram?

Escitalopram is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). SSRIs are the most frequently prescribed antidepressants.

Escitalopram is used to treat a number of mental health conditions including depression, obsessive-compulsive disorder, and anxiety.

It is believed that SSRIs work by increasing the levels of a chemical called serotonin. This helps enhance mood. You should notice that you sleep better and feel more relaxed.

Read more about antidepressants and SSRIs.

Dose

In Aotearoa New Zealand escitalopram is available as tablets (10 mg, 20 mg).

  • The usual dose of escitalopram is 10 mg once a day.
  • Depending on your response, and if you need to, your doctor may increase your dose to 20 mg once a day.
  • Always take your escitalopram exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much escitalopram to take, how often to take it and any special instructions. 

How to take escitalopram

  • Take escitalopram once a day, at the same time each day, either in the morning OR in the evening. 
  • Food: You can take escitalopram with or without food but if you think it is upsetting your stomach, try taking it with food. Take your dose with a full glass of water.
  • Missed dose: If you forget to take your tablet, take it as soon as you remember. But, if it is nearly time for your next tablet, just take the next tablet at the right time. Do not take double the amount of tablets.
  • Keep taking escitalopram every day. It may take 4 to 6 weeks before you notice the full benefits of escitalopram and you should start to feel better after 1 to 2 weeks. Some people feel worse in the first few weeks before they feel better. Escitalopram is often needed for at least a few months and your doctor will tell you how long to take it for.
  • If you think escitalopram is not working for you. Do not stop taking it suddenly; speak to your doctor or nurse before stopping. It is usually best to stop taking escitalopram very slowly to avoid side effects.

Read more about what to expect when starting SSRIs – see SSRIs and frequently asked questions (FAQs) about SSRIs.

Precautions

Diabetes: if you have diabetes, you may need to check your blood glucose more often because escitalopram can affect the levels of glucose in your blood.

Interactions with other medicines and herbal supplements: Escitalopram  can interact with some medications (including anticoagulants and NSAIDs), herbal supplements, and recreational drugs, so check with your doctor or pharmacist before starting escitalopram and before starting any new products.

Possible side effects

Like all medicines, escitalopram can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine. 

Side effects What should I do?
  • Nausea (feeling sick)
  • Headache
  • Dry mouth
  • Increased sweating
  • Diarrhoea (runny poos)
  • These are quite common at the start of treatment.
  • If you have nausea, try taking your dose with food.
  • For headaches, stay hydrated and take paracetamol.
  • Read about how to treat diarrhoea or dry mouth.
  • Difficulty falling asleep
  • This is quite common. Try taking your dose in the morning
  • Feeling sleepy, drowsy, dizzy or tired
  • Difficulty concentrating
  • These are quite common. 
  • Try taking your dose in the evening
  • Be careful when driving or using tools until you know how this medicine affects you
  • Avoid drinking alcohol. Read more about how alcohol affects medicines.
  • Feeling less or more hungry than usual
  • This is common but tell your doctor if they cause you problems.
  • Changes in weight (increase or decrease)
  • Loss of sex drive or libido
  • Problems with keeping an erection or ejaculation
  • Some vaginal bleeding
  • These are common at the start of treatment but tell your doctor if they cause you problems or if they are severe.
  • The good effects of escitalopram may, after a while, improve your sex life as your mood lifts and you become interested in life and relationships again.
  • Read more about medicines and sexual problems.
  • Suicidal feelings or behaviour such as agitation, aggression, self-harm, worsening of low mood.
  • These are rare but serious side effects
  • They are most likely to happen during the start of treatment or when doses are changed
  • Contact your doctor immediately
  • For urgent help contact Healthline 0800 611 116 or Lifeline 0800 543 354 (available 24/7).
  • Signs of serotonin syndrome such as feeling agitated and restless, heavy sweating, shivering, fast heart rate or irregular heart beat, severe headache, severe or ongoing diarrhoea and rigid or twitching muscles.
  • These are rare but serious side effects
  • You are at increased risk of serotonin syndrome if you just started taking escitalopram or increased the dose or started other medicines that can cause serotonin syndrome
  • Tell your doctor immediately or ring HealthLine 0800 611 116
For more information on side effects, see the Medsafe consumer information leaflet below. 

Did you know that you can report a medicine side effect to the Centre for Adverse Reactions Monitoring (CARM)? Report a side effect to a product

Learn more

The following links provide more information on escitalopram:

Escitalopram Patient Information (Māori) NZ Formulary, NZ
Escitalopram (Apotex) Medsafe Consumer Information Sheet, NZ Note this is a different brand to that currently funded (Escitalopram (Ethics)

References

  1. Escitalopram NZ Formulary, NZ
  2. Escitalopram (Ethics) Medsafe Product Information NZ
  3. Selective serotonin re-uptake inhibitors NZ Formulary, NZ
  4. The role of medicines in the management of depression in primary care BPAC, NZ
  5. Citalopram and escitalopram – same but different SafeRX, NZ

Additional resources for healthcare professionals

Reminder – citalopram and qt prolongation Medsafe, NZ, 2015
The role of medicines in the management of depression in primary care BPAC, NZ, 2017

Credits: Sandra Ponen, Pharmacist. Reviewed By: Maya Patel, Pharmacist, Auckland Last reviewed: 03 Apr 2022