Escitalopram

What is this medication for?

Escitalopram belongs to a class of medications known as Selective Serotonin Reuptake Inhibitors (SSRI). It is used to treat symptoms of depression such as: 

• Feeling sad
• Loss of interest in usual activities
• Feeling hopeless or useless
• Feeling bad about yourself
• Thoughts of ending your life
• Poor sleep, energy or appetite

It may also be used to treat symptoms of anxiety such as: 

• Feeling constantly worried and helpless
• Very fast heartbeat
• Uncontrolled shaking of body parts such as hands (tremors)
• Sweating
• Nervousness 

Escitalopram may also be used for obsessive-compulsive disorders and other conditions. Check with your healthcare professional if you are unsure why you are given this medication.

You can also find out about this medication by watching these videos:

For videos in 中文, Melayu and தமிழ், click here: Escitalopram

How should I take or use this medication?

• Escitalopram should be taken with or after food
• Take your medication according to the instructions stated on the medication label
• Do not stop taking or adjust the dose of this medication without checking with your doctor
• Escitalopram needs to be taken regularly for a few weeks before you can feel its full benefits. You should not stop taking this medication even if you do not feel better at the beginning. Continue to take this medication even after you feel better to prevent your symptoms from returning
• Do check with your doctor on how long you will have to be on this medication
• You may experience unpleasant effects such as dizziness, headache, difficulty sleeping, irritability, and nausea if you suddenly stop taking the medication on your own

What should I do if I forget to take or use this medication?

• If you forget to take a dose, take it as soon as you remember. However, if more than half of the time to the next dose has passed, skip the missed dose and take the next dose at your usual timing
• For example, for a medication to be taken two times daily at 8am and 8pm, and you missed your first dose at 8am, skip the first dose if it is after 2pm, and take your second dose at the usual timing at 8pm. Do not take two doses to make up for the missed dose

What precautions should I take when taking or using this medication?

Inform your healthcare professional if: 

• You are allergic to this medication or any of the other ingredients of this medication
• You are pregnant, planning to become pregnant, or breastfeeding. If you are pregnant and/or breastfeeding, your doctor would have discussed the potential benefits and side-effects with you and should you have further questions or concerns, do consult your doctor.
• You are taking any other medications (including those that can be bought without a prescription), supplements such as St John’s Wort, traditional medications and herbal remedies. Some of them may affect how this medication works or cause serious drug interactions.
• You have or have ever had:
  • Other drug allergies
  • Heart, kidney or liver disease
  • Medical conditions such as diabetes, seizures (fits), Parkinson’s disease, increased eye pressure (glaucoma), low sodium in the blood (hyponatremia) or bleeding problems
  • Other mental health conditions such as bipolar disorder, abnormally high or excited mood (mania)
  • Been taking other medications for low mood in the past 2 weeks

IMPORTANT: 

The following changes have been observed in some patients particularly below the age of 25 years taking this medication: 

• New or worsening thoughts of harming yourself or ending your life
• Worsening agitation, restlessness, violent behaviour, or
• Other changes in mood or behaviour 

These changes may more likely occur during the first few weeks of starting or changing the dosage of the medication. It is currently unclear if these symptoms are due to the severity of the illness or other reasons. 

If you experience any of the above changes, please inform your doctor as soon as possible, or ask your family/ or caregiver to inform your doctor if you are unable to do so yourself. Do not stop taking this medication on your own without discussing with your doctor.

What are some common side effects of this medication? ​

• Nausea, vomiting or loss of appetite
  • Take the medication with or after food
  • Take small but more frequent meals, and avoid fatty or spicy food
• Drowsiness or feeling tired
  • Avoid driving or taking part in activities that require focus
  • Discuss with your doctor if you can take your medication at a different time of the day
• Dizziness
  • Get up slowly from a sitting or lying down position
• Difficulty sleeping
  • Discuss with your doctor if you can take your medication at a different time of the day
  • Listen to relaxing music at bedtime
  • Avoid eating or drinking too much before bedtime
  • Limit caffeine intake (such as coffee, tea or energy drinks) at least 8 hours before bedtime
• Diarrhoea
  • Drink plenty of water to replace the loss of fluids
• Dry mouth
  • Chew sugar-free gum, suck on sugar-free hard candies or ice chips, and sip water regularly
• Constipation
  • Drink more water (if you do not have any fluid restriction), eat more high-fibre foods, and exercise regularly
  • Speak to your doctor or pharmacist if you need medication to help with your constipation
• Mild nervousness, trembling or increased sweating
  • May occur at the start of treatment but usually improves over time with continued medication taking
• Headache
• Decreased sexual drive or ability 

Most of the side effects listed here will improve with time. Speak with your doctor if they continue, get worse or are affecting your daily life.

What are some rare but serious side-effects that I need to seek medical advice immediately? 

 The symptoms of a drug allergy include one or more of the following: 

• Swollen face/eyes/lips/tongue
• Difficulty in breathing
• Itchy skin rashes over your whole body

You can also find out about drug allergies by watching these videos:

For videos in 中文, Melayu and தமிழ், click here: Drug Allergies

Rarely, this medication may cause:

• Seizures (fits)
• Unexplained fever, confusion, fast heartbeat, severe weakness, uncontrolled movements, or twitching of the muscles (signs and symptoms of serotonin syndrome)
• Feelings of intense agitation or anxiety, restlessness, or inability to sit still
• Unusual thoughts, talking, feeling, and acting with excitement that you cannot control (signs and symptoms of mania)
• Feeling confused, muscle weakness/cramps, having difficulty focusing or remembering things, feeling unsteady when walking (signs and symptoms of low sodium in the blood)
• Unusual bruising or bleeding, such as:
  • Blood in urine
  • Black and sticky stools (if you are not using iron supplements at the same time)
  • Coughing up blood/coffee ground-like vomit
• Fast or irregular heartbeat, fainting episodes (signs and symptoms of an abnormal heart beating rhythm (e.g. prolonged QTc interval))

If you experience any of these symptoms, you should stop your medication and see your healthcare professional immediately.

What food or medication should I avoid when I take or use this medication?

Avoid drinking alcohol while taking Escitalopram as it can worsen the symptoms of your depression and cause excessive sleepiness.

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How do I throw away this medication safely? ​

Pack this medication into a trash bag and seal it tightly before throwing into the rubbish chute or bin.