Escitalopram – Modern SSRI antidepressant for depression and anxiety.
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What is Escitalopram?
Escitalopram is a modern SSRI antidepressant that’s often considered to have fewer side effects and drug interactions compared to other SSRIs. It’s effective for treating depression and various anxiety disorders, with many people finding it well-tolerated.
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What is Escitalopram used for?
- Major depressive disorder
- Generalised anxiety disorder
- Panic disorder
- Social anxiety disorder
- Obsessive-compulsive disorder (OCD)
- Post-traumatic stress disorder (PTSD)
How does Escitalopram work?
A selective serotonin reuptake inhibitor (SSRI) that increases serotonin levels in the brain by preventing its reuptake, helping to improve mood, reduce anxiety, and alleviate other symptoms.
Dosage and Administration
Adults
Starting dose 10mg daily, may be increased to 20mg daily if needed. Maximum 20mg daily.
Children
Not recommended for children and adolescents under 18 years.
Important Notes
- Take at the same time each day, preferably in the morning.
- Can be taken with or without food.
- May take 4-6 weeks to feel full benefits.
- Do not stop suddenly—gradual dose reduction required.
Side Effects
Common Side Effects
- Nausea and stomach upset
- Headache
- Diarrhoea or constipation
- Dizziness
- Sleep disturbances (insomnia or drowsiness)
- Sexual side effects
- Dry mouth
- Increased sweating
Serious Side Effects
Seek immediate medical attention if you experience:
- Thoughts of self-harm or suicide (especially when starting)
- Serotonin syndrome (confusion, rapid heart rate, high fever)
- Severe allergic reactions
- Abnormal bleeding or bruising
- Low sodium levels (hyponatraemia)
- Heart rhythm changes (QT prolongation)
Important Warnings
- May initially increase thoughts of self-harm, especially in young adults—close monitoring required.
- Do not stop taking suddenly—risk of discontinuation syndrome.
- May affect your ability to drive or operate machinery initially.
- Tell your GP if you have heart problems, epilepsy, or bleeding disorders.
- Avoid alcohol as it may worsen side effects and interfere with treatment.
Drug Interactions
Tell your GP if you're taking any of the following medications:
- MAOIs (monoamine oxidase inhibitors)—dangerous interaction, avoid completely.
- Other antidepressants—risk of serotonin syndrome.
- Warfarin and blood thinners—increased bleeding risk.
- NSAIDs (ibuprofen, aspirin)—increased bleeding risk.
- Tramadol and certain painkillers—risk of serotonin syndrome.
- St John's Wort—avoid this herbal supplement.
Frequently Asked Questions
How is Escitalopram different from Sertraline?
Both are SSRIs but Escitalopram often has fewer side effects and drug interactions. It may be preferred for people who experienced side effects with other SSRIs.
Why can't teenagers take Escitalopram?
Studies show increased risk of suicidal thoughts in under-18s. Other treatments are usually tried first in this age group.
What is discontinuation syndrome?
Stopping SSRIs suddenly can cause flu-like symptoms, dizziness, and brain 'zaps'. Your GP will help you reduce the dose gradually when stopping.
Will Escitalopram affect my sex life?
Sexual side effects are common with SSRIs, including reduced libido and delayed orgasm. These often improve with time, but discuss with your GP if problematic.
Medically Reviewed by: Mohammed Hassan - Independent Prescriber
Last Updated: 2025-01-14