This article is about the left handed version of the medication. For its racemic form, see citalopram. Common side effects include trouble sleeping, nausea, sexual problems, and feeling tired. More serious side antidepressant pills for teenagers may include suicide in people under the age of 25.
Escitalopram was approved for medical use in the United States in 2002. In the United States the wholesale cost is about 2. 04 USD per month as of 2017. In the United Kingdom in 2015, escitalopram was more than 20 times as expensive as citalopram. Escitalopram has FDA approval for the treatment of major depressive disorder in adolescents and adults, and generalized anxiety disorder in adults. Escitalopram was approved by regulatory authorities for the treatment of major depressive disorder on the basis of four placebo controlled, double-blind trials, three of which demonstrated a statistical superiority over placebo.
Controversy existed regarding the effectiveness of escitalopram compared to its predecessor citalopram. The importance of this issue followed from the greater cost of escitalopram relative to the generic mixture of isomers citalopram prior to the expiration of the escitalopram patent in 2012, which led to charges of evergreening. Accordingly, this issue has been examined in at least 10 different systematic reviews and meta analyses. In contrast to these findings, a 2011 review concluded that all second-generation antidepressants are equally effective, although may differ in onset and side effects. Treatment guidelines issued by the National Institute of Health and Clinical Excellence and by the American Psychiatric Association generally reflect this viewpoint. In 2018, a systematic review and network meta-analysis comparing the efficacy and acceptability of 21 antidepressant drugs showed escitalopram to be one of the most effective antidepressants in head-to-head studies. Escitalopram, as well as other SSRIs, are effective in reducing the symptoms of premenstrual syndrome, whether taken in the luteal phase only or continuously.
Escitalopram, like other SSRIs, has been shown to affect sexual functions causing side effects such as decreased libido, delayed ejaculation, and anorgasmia. An analysis conducted by the FDA found a statistically insignificant 1. Escitalopram is not associated with weight gain. Some people experience persistent sexual side effects after they stop taking SSRIs.
There is a tentative association of SSRI use during pregnancy with heart problems in the baby. The advantages of their use during pregnancy should thus outweigh the possible negative effects on the baby. Excessive doses of escitalopram usually cause relatively minor untoward effects, such as agitation and tachycardia. However, dyskinesia, hypertonia, and clonus may occur in some cases. Escitalopram increases intrasynaptic levels of the neurotransmitter serotonin by blocking the reuptake of the neurotransmitter into the presynaptic neuron. Escitalopram is a substrate of P-glycoprotein and hence P-glycoprotein inhibitors such as verapamil and quinidine may improve its blood brain barrier penetrability.
As escitalopram is only a weak inhibitor of CYP2D6, analgesia from tramadol may not be affected. Escitalopram can also prolong the QT interval and hence it is not recommended in patients that are concurrently on other medications that also have the ability to prolong the QT interval. Escitalopram was developed in close cooperation between Lundbeck and Forest Laboratories. Its development was initiated in the summer of 1997, and the resulting new drug application was submitted to the U. The FDA issued the approval of escitalopram for major depression in August 2002 and for generalized anxiety disorder in December 2003.
On May 23, 2006, the FDA approved a generic version of escitalopram by Teva. This pushed the patent expiration date from December 7, 2009 to September 14, 2011. Together with the 6-month pediatric exclusivity, the final expiration date was March 14, 2012. In 2004, two separate civil suits alleging illegal marketing of citalopram and escitalopram for use by children and teenagers by Forest were initiated by two whistleblowers, one by a practicing physician named Joseph Piacentile, and the other by a Forest salesman named Christopher Gobble. In February 2009, these two suits received support from the US Attorney for Massachusetts and were combined into one. Escitalopram is sold under many brand names worldwide such as Cipralex and Lexapro. The American Society of Health-System Pharmacists.