escitalopram LEXAPRO

Class: SSRI
FDA Indications: MDD, GAD
Off-Label Use: Fibromyalgia, Agitation In Alzheimers Disease
Forms: 5, 10, 20mg tablet; 5mg/5mL po soln
Dose Range: 5-20 mg/day
Starting: Start at 5 mg QHS because initial sedation is common. Target dose of 10-20 mg for most patients.

NAMI drug fact sheet

Contraindications: Concomitant use of MAOIs
Serious Side Effects: Serotonin syndrome; ↑ risk of SI in children and young adults; may impair platelet aggregation; SIADH
Known Risk of TdP
Side Effects: nausea, fatigue, sexual dysfunction, insomnia
1° MOA: Selective serotonin reuptake inhibitor
Target: SERT
t½: 30 (27-33)° TMAX: 3-4°
Substrate of: 3A4, 2C19
Inhibits: 2D6 (mild); Induces:
Active Metabolites:
  • - lowest potential for drug interactions among the SSRIs
  • - S-isomer of citalopram
  • - most selective serotonin reuptake inhibitor
  • - 2nd highest risk of QTc prolongation in its class; mean QTc prolongation at various doses
    • 10mg: 4.5ms
    • 20mg: 6.6ms
    • 30mg: 10.7ms
  • - has the fewest side effects of all the SSRIs
  • - linear & dose-proportional pharmacokinetics
Special Populations

Category C—Human pregnancy experience is limited. Animal data suggest that risk to an embryo-fetus is low. Two large case-control studies did find ↑ risks for some birth defects, but the absolute risk appears to be low. A large prospective cohort that adjusted for many confounders did not find an ↑'d risk. However, SSRIs have been assoc w/ developmental toxicities, including SABs, ↓ birth weight, prematurity, neonatal serotonin syndrome, neonatal behavioral syndrome (withdrawal), respiratory distress, and PPHN

RID 3-8.3%; ∅AE's were reported in 2 case reports

Clearance values ~30% ↓ than younger controls; has been associated with cases of clinically significant hyponatremia in elderly patients

No dosing adjustment required in moderate renal impairment

10 mg is the recommended dose for most hepatically impaired patients


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Last updated February 29 2024 20:54:18. Disclaimer: This website does not provide medical advice, nor is it a substitute for clinical judgment.