• Basic Info
• Top Questions
• Clinical Info
• Interactions

Actions

• S-enantiomer of citalopram, an SSRI that occurs as a 50:50 racemic mixture of the R- and S-enantiomers.
• At least 100-fold more potent as an inhibitor of serotonin (5-hydroxytryptamine [5-HT]) reuptake at presynaptic membranes and 5-HT neuronal firing rate than R-enantiomer and is twice as potent as racemic mixture.
• Mechanism of action as an antidepressant is presumed to be linked to potentiation of serotonergic activity in the CNS resulting from its inhibition of CNS neuronal reuptake of serotonin (5-HT).
• Highly selective; minimal effects on norepinephrine (NE) and dopamine (DA) neuronal reuptake and little or no affinity for α- or β-adrenergic, dopamine D_1–5, histamine H_1–3, GABA-benzodiazepine, muscarinic M_1–5, or 5-HT_1–7 receptors or various ion channels (e.g., calcium, chloride, potassium, sodium channels).

Advice to Patients

• Risk of suicidality; importance of patients, families, and caregivers being alert to and immediately reporting emergence of suicidality, worsening depression, or unusual changes in behavior, especially during the first few months of therapy or during periods of dosage adjustment. FDA recommends providing written patient information (medication guide) explaining risks of suicidality each time the drug is dispensed.
• Risk of psychomotor impairment; importance of exercising caution while operating hazardous machinery, including automobile driving, until they gain experience with the drug’s effects.
• Risks associated with concomitant use of escitalopram with alcohol or racemic citalopram.
• Importance of continuing escitalopram therapy even if a response is not evident within 1–4 weeks, unless directed otherwise.
• Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.
• Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs, as well as any concomitant illnesses (e.g., bipolar disorder) or personal or family history of suicidality or bipolar disorder.
• Importance of informing patients of risk of serotonin syndrome with concurrent use of escitalopram and 5-HT₁ receptor agonists (“triptans”) or other serotonergic agents. Importance of seeking immediate medical attention if symptoms of serotonin syndrome develop.
• Importance of informing patients of other important precautionary information. (See Cautions.)

Preparations

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.

AHFS Drug Information. © Copyright, 1959-2008, Selected Revisions August 2007. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.