Escitalopram: Difference between revisions
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In [[psychiatry]], '''escitalopram''' is a [[second-generation antidepressant]] for treating [[major depressive disorder]]. Escitalopram is the S-enantiomer of racemic [[citalopram]].<ref name="pmid19370639">{{cite journal| author=Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H et al.| title=Escitalopram versus other antidepressive agents for depression. | journal=Cochrane Database Syst Rev | year= 2009 | volume= | issue= 2 | pages= CD006532 | pmid=19370639 | In [[psychiatry]], '''escitalopram''' is a [[second-generation antidepressant]] for treating [[major depressive disorder]]. It is also effective in reducing [[ethanol]] uptake in [[alcoholism|alcoholics]] and is used in depressed patients who also suffer from [[tardive dyskinesia]] in preference to [[tricyclic antidepressant]]s, which aggravate this condition. <ref> {{MeSH}}</ref> | ||
Escitalopram is the S-enantiomer of racemic [[citalopram]].<ref name="pmid19370639">{{cite journal| author=Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H et al.| title=Escitalopram versus other antidepressive agents for depression. | journal=Cochrane Database Syst Rev | year= 2009 | volume= | issue= 2 | pages= CD006532 | pmid=19370639 | |||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=19370639 | doi=10.1002/14651858.CD006532.pub2 }} </ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=19370639 | doi=10.1002/14651858.CD006532.pub2 }} </ref> | ||
==History== | ==History== | ||
''Lexapro'' brand of escitalopram was approved by the [[Food and Drug Administration]] in the [[United States]] with a [http://www.fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/ApprovalApplications/NewDrugApplicationNDA/ New Drug Application] (NDA) in 2002.<ref>[http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.SearchAction&SearchType=BasicSearch&Search_Button=Submit&searchTerm=021323 Drugs@FDA].</ref> | ''Lexapro'' brand of escitalopram was approved by the [[Food and Drug Administration]] in the [[United States of America]] with a [http://www.fda.gov/Drugs/DevelopmentApprovalProcess/HowDrugsareDevelopedandApproved/ApprovalApplications/NewDrugApplicationNDA/ New Drug Application] (NDA) in 2002.<ref>[http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.SearchAction&SearchType=BasicSearch&Search_Button=Submit&searchTerm=021323 Drugs@FDA].</ref> | ||
==Efficacy== | ==Efficacy== | ||
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| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=19370639 | doi=10.1002/14651858.CD006532.pub2 }} </ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=19370639 | doi=10.1002/14651858.CD006532.pub2 }} </ref> | ||
:"Some statistically significant differences favouring escitalopram over other [[antidepressant|antidepressive agent]]s for the acute phase treatment of major depression were found, in terms of efficacy ([[citalopram]] and [[fluoxetine]]) and acceptability ([[duloxetine]]). There is insufficient evidence to detect a difference between escitalopram and other antidepressants in early response to treatment (after two weeks of treatment). Cost-effectiveness information is also needed in the field of antidepressant trials. Furthermore, as with most standard systematic reviews, the findings rely on evidence from direct comparisons. The potential for overestimation of treatment effect due to sponsorship bias should also be borne in mind." | :"Some statistically significant differences favouring escitalopram over other [[antidepressant|antidepressive agent]]s for the acute phase treatment of major depression were found, in terms of efficacy ([[citalopram]] and [[fluoxetine]]) and acceptability ([[duloxetine]]). There is insufficient evidence to detect a difference between escitalopram and other antidepressants in early response to treatment (after two weeks of treatment). Cost-effectiveness information is also needed in the field of antidepressant trials. Furthermore, as with most standard systematic reviews, the findings rely on evidence from direct comparisons. The potential for overestimation of treatment effect due to sponsorship bias should also be borne in mind." | ||
==Pharmacology== | |||
===Administration=== | |||
===Distribution=== | |||
===Metabolism=== | |||
Escitalopram is metabolised by [[cytochrome P-450]] CYP3A4 and [[Cytochrome P-450 CYP2C19|CYP2C19]]. | |||
===Excretion=== | |||
==Toxicity== | |||
[[Drug toxicity]] include: | |||
* Prolongation of the [[QT interval]]<ref name="pmid19556032">{{cite journal| author=van Gorp F, Whyte IM, Isbister GK| title=Clinical and ECG effects of escitalopram overdose. | journal=Ann Emerg Med | year= 2009 | volume= 54 | issue= 3 | pages= 404-8 | pmid=19556032 | doi=10.1016/j.annemergmed.2009.04.016 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19556032 }} </ref> | |||
* [[Hyponatremia]]<ref name="pmid17202465">{{cite journal| author=Covyeou JA, Jackson CW| title=Hyponatremia associated with escitalopram. | journal=N Engl J Med | year= 2007 | volume= 356 | issue= 1 | pages= 94-5 | pmid=17202465 | doi=10.1056/NEJMc062840 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17202465 }} </ref> | |||
==External links== | ==External links== | ||
Latest revision as of 13:18, 2 February 2023
In psychiatry, escitalopram is a second-generation antidepressant for treating major depressive disorder. It is also effective in reducing ethanol uptake in alcoholics and is used in depressed patients who also suffer from tardive dyskinesia in preference to tricyclic antidepressants, which aggravate this condition. [1]
Escitalopram is the S-enantiomer of racemic citalopram.[2]
History
Lexapro brand of escitalopram was approved by the Food and Drug Administration in the United States of America with a New Drug Application (NDA) in 2002.[3]
Efficacy
According to a systematic review by the Cochrane Collaboration:[2]
- "Some statistically significant differences favouring escitalopram over other antidepressive agents for the acute phase treatment of major depression were found, in terms of efficacy (citalopram and fluoxetine) and acceptability (duloxetine). There is insufficient evidence to detect a difference between escitalopram and other antidepressants in early response to treatment (after two weeks of treatment). Cost-effectiveness information is also needed in the field of antidepressant trials. Furthermore, as with most standard systematic reviews, the findings rely on evidence from direct comparisons. The potential for overestimation of treatment effect due to sponsorship bias should also be borne in mind."
Pharmacology
Administration
Distribution
Metabolism
Escitalopram is metabolised by cytochrome P-450 CYP3A4 and CYP2C19.
Excretion
Toxicity
Drug toxicity include:
- Prolongation of the QT interval[4]
- Hyponatremia[5]
External links
The most up-to-date information about Escitalopram and other drugs can be found at the following sites.
- Escitalopram - FDA approved drug information (drug label) from DailyMed (U.S. National Library of Medicine).
- Escitalopram - Drug information for consumers from MedlinePlus (U.S. National Library of Medicine).
- Escitalopram - Detailed information from DrugBank.
References
- ↑ Anonymous (2024), Escitalopram (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ 2.0 2.1 Cipriani A, Santilli C, Furukawa TA, Signoretti A, Nakagawa A, McGuire H et al. (2009). "Escitalopram versus other antidepressive agents for depression.". Cochrane Database Syst Rev (2): CD006532. DOI:10.1002/14651858.CD006532.pub2. PMID 19370639. Research Blogging.
- ↑ Drugs@FDA.
- ↑ van Gorp F, Whyte IM, Isbister GK (2009). "Clinical and ECG effects of escitalopram overdose.". Ann Emerg Med 54 (3): 404-8. DOI:10.1016/j.annemergmed.2009.04.016. PMID 19556032. Research Blogging.
- ↑ Covyeou JA, Jackson CW (2007). "Hyponatremia associated with escitalopram.". N Engl J Med 356 (1): 94-5. DOI:10.1056/NEJMc062840. PMID 17202465. Research Blogging.