WHAT YOU NEED TO KNOW ABOUT Lexapro?
What is Lexapro?
Lexapro belongs to the class of selective serotonin reuptake inhibitors. Lexapro affects unbalanced chemicals in the brain, causing depression.
Lexapro is used for treating depression.
Lexapro may be used for other purposes not listed in this medication guide.
APPLICATION Lexapro:
Take Lexapro exactly as directed by your doctor. To clarify the indications for use, contact your doctor or pharmacist.
Take each dose with a full glass of water (200 ml).
In order to accurately measure the dose, use a measuring spoon or cup, not a regular table spoon. Ask your pharmacist where you can get scoop / cup, if they do not.
Lexapro may be taken with or without food.
Typically, Lexapro taken once a day. Follow your doctor's instructions. Take the medicine on a daily basis in the bottom and at the same time.
Do not stop taking Lexapro without consulting your doctor. Improvement can occur within a few weeks.
Store Lexapro at room temperature away from moisture and heat.
What should be discussed with your doctor before taking Lexapro?
Do not start treatment Lexapro if you are taking a monoamine oxidase inhibitor (MAOI) such as isocarboxazid (Marplan), tranylcypromine (Parnate), or phenelzine (Nardil) in the last 2 weeks. The interaction of these drugs with Lexapro can be dangerous.
Before taking Lexapro, tell your doctor if you have:
- liver disease
- kidney disease
- or cramps
- mania or suicidal thoughts.
You will not be able to take Lexapro, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
Lexapro should not be taken at the same time c citalopram (tseleksoy). If you have an allergic reaction to citalopram (tseleksu), an allergic reaction can occur, and after taking Lexapro. Do not start taking this medication without first talking to your doctor if in the past you have an allergic reaction to similar medications.
Lexapro belongs to category C classification FDA pregnancy. This means that the harmful effects of the drug on the fetus has not been proved. Do not take Lexapro if you are pregnant or could become pregnant during treatment medication without first talking to your doctor.
Lexapro passes into breast milk and may affect a nursing infant. If you are breast-feeding, do not take Lexapro without consulting your doctor.
PRECAUTIONS FOR ADMISSION Lexapro
Use caution when driving, operating machinery, or performing other hazardous activities. Lexapro may cause dizziness. If you have dizziness, avoid these activities.
Caution must be exercised in the use of alcohol. Alcohol may increase drowsiness and dizziness caused by Lexapro or affect your condition.
Indications:
Escitalopram is indicated for the treatment of depression, panic disorders (including agoraphobia).
Contraindications:
Simultaneous treatment with MAO inhibitors, childhood and adolescence to 15 years, pregnancy, lactation, hypersensitivity to escitalopram.
Carefully:
C Caution should be used in patients with renal insufficiency (creatinine clearance less than 30 ml / min), hypomania, mania, at pharmacologically uncontrolled epilepsy, depression with suicidal attempts, diabetes, elderly patients with cirrhosis of the liver, a tendency to bleeding simultaneously with taking drugs that reduce the seizure threshold, causing hyponatremia, with ethanol, with drugs metabolized with the participation of isoenzymes CYP2C19 system.
Pregnancy and lactation:
Category effects on the fetus by FDA - C. There are no adequate and well-controlled studies safety of escitalopram use in pregnant women has not done. Do not apply.
Infants who were exposed to escitalopram and other selective inhibitors of the reuptake of serotonin reuptake inhibitor of serotonin and norepinephrine in the end of III trimester of the mother's pregnancy, developed complications requiring prolonged hospitalization, respiratory support, nutrition through a tube. Such complications can occur immediately after delivery. Noted clinical signs included: respiratory distress, cyanosis, apnea, seizures, temperature unstable, difficulty in feeding, vomiting, hypoglycemia, hypotonia, hyperreflexia, tremor, nervous agitation, irritability, continuous crying.
These symptoms are associated with either a direct toxic effect of selective serotonin reuptake inhibitors or serotonin reuptake inhibitors and norepinephrine, or perhaps, are the manifestations of withdrawal reactions in the newborn. In some cases, the clinical picture was similar to the development of serotonin syndrome.
If the patient takes escitalopram during the III trimester of pregnancy, the doctor should carefully evaluate the risk / benefit ratio, and the need to consider the possibility of withdrawal reactions (a drug discontinuation syndrome) in a newborn. The doctor may decide to phase out the treatment with escitalopram in III trimester.
Effect of escitalopram oxalate on labor and delivery in humans is not known.
Lactation. Nursing women should discontinue either breast-feeding or receiving escitalopram oxalate.
Dosage and administration:
Inside, regardless of meals. Depending on the indication single dose - 10-20 mg per day. The maximum daily dose - 20 mg. Duration of treatment - a few months. Upon termination of the treatment the dose should be gradually reduced over 1-2 weeks to avoid the syndrome of "cancellation".
For elderly patients (over 65 years), the recommended dose - 5 mg per day, maximum daily dose - 10 mg.
If abnormal liver function recommended starting dose for the first 2 weeks of treatment is 5 mg per day. Depending on the individual response the dose can be increased to 10 mg per day.
For patients with weak activity CYP2C19 isozyme recommended starting dose for the first 2 weeks of treatment - 5 mg per day. Depending on the individual response the dose can be increased to 10 mg per day.
Side effects:
From the central and peripheral nervous system: dizziness, weakness, insomnia or drowsiness, seizures, tremor, movement disorders, serotonin syndrome (agitation, tremor, myoclonus, hyperthermia), hallucinations, delusions, confusion, agitation, anxiety, depersonalisation, panic attacks , increased irritability, and visual disturbances.
From the digestive system: nausea, vomiting, dryness of the oral mucosa, impaired sense of taste, decreased appetite, diarrhea, constipation, changes in laboratory parameters of liver function.
- Since the cardiovascular system: orthostatic hypotension.
- From endocrine system: reduction of ADH secretion, galactorrhea.
- From the reproductive system: decreased libido, impotence, ejaculation disorder, anorgasmia (in women).
- From the urinary system: urinary retention.
- Dermatological reactions: skin rash, pruritus, ecchymosis, purpura, sweating.
- Allergic reactions: angioedema, anaphylactic reactions.
- From a metabolism: hyponatremia, hyperthermia.
- From the Musculoskeletal System: arthralgia, myalgia.
Other: sinusitis, "cancellation" syndrome (dizziness, headaches and nausea).
Overdose:
In clinical trials of escitalopram have been reports of overdose (of up to 600 mg) of non-fatal.
Treatment: to achieve and maintain airway patency for adequate ventilation and oxygenation, gastric lavage and administration of activated charcoal. Recommended close observation and monitoring of vital functions, including heart function, symptomatic and supportive therapy. Due to the large volume of distribution of escitalopram unlikely efficiency activities such as forced diuresis, dialysis, hemoperfusion and exchange transfusion. There is no specific antidote.
Special instructions:
Escitalopram should be administered only after 2 weeks after the cancellation of irreversible MAO inhibitors, and 24 hours after the cessation of therapy, reversible inhibitor of MAO. Non-selective MAO inhibitors may be administered no earlier than 7 days after discontinuation of escitalopram.
Some patients with panic disorder, early treatment can be observed escitalopram increased anxiety, which usually disappears within 2 weeks following treatment. To reduce the chance of an alarm, it is recommended to use a low initial dose.
Escitalopram should be repealed in the event of seizures or increased rates pharmacologically uncontrolled epilepsy.
With the development of mania escitalopram should be discontinued.
Escitalopram is able to increase in the blood glucose concentration in diabetes, which may require dose adjustment of hypoglycemic drugs.
Clinical experience with escitalopram indicates a possible increase in the risk of suicide attempts in the realization of the first week of therapy, and therefore it is very important to carry out careful monitoring of the patients during this period.
Hyponatremia, associated with a decrease in the secretion of ADH, while taking escitalopram is rare and usually disappears when it is canceled.
With the development of serotonin syndrome escitalopram should be immediately withdrawn and symptomatic treatment.
During treatment, patients should avoid driving and other activities that require high concentration and speed of psychomotor reactions.
Application
The drug is prescribed 1 p / day, regardless of the meal. If depressive episodes, the drug is usually prescribed at a dose of 10 mg / day. Depending on the individual response of the patient the dose may be increased to a maximum of - 20 mg / day. Antidepressant effect usually develops within 2-4 weeks after starting treatment. After the disappearance of the symptoms of depression for at least a further 6 months is necessary to continue treatment for fixing the resulting effect.
When panic disorder with / without agoraphobia during the 1st week of treatment recommended dose of 5 mg / day, followed by an increase to 10 mg / day. Depending on the individual response of the patient the dose may be increased to a maximum of - 20 mg / day. The maximum therapeutic effect is reached after about 3 months after initiation of treatment.
The therapy lasts several months. Elderly patients (over 65 years) is usually recommended to use half the recommended dose (ie. E. Only 5 mg / day) and a lower maximum dose (10 mg / day).
Patients with severe renal insufficiency (creatinine clearance less than 30 ml / min), the drug should be used with caution. Patients with impaired hepatic function The recommended starting dose for the first 2 weeks of treatment is 5 mg / day. Depending on the individual response to the medication dose can be increased to 10 mg / day.
With reduced activity isoenzyme CYP2C19 the recommended starting dose for the first 2 weeks of treatment is 5 mg / day. Depending on the individual response to the medication dose can be increased to 10 mg / day. Upon termination of the treatment the dose should be reduced gradually over 1-2 weeks to avoid the development of the syndrome.
Lexapro and weight gain
Up to 25% of people taking antidepressants, weight gain. Can this something to do?
Asking for help with depression and treated with antidepressants - a bold and important first step on the road to recovery. But too often, those who follow this path are faced with another problem - the threat of weight gain.
According to experts, up to 25% of people taking the majority of antidepressants - including the popular Now SSRIs (selective serotonin reuptake inhibitor) - such as Prozac, Lexapro, Paxil and Zoloft - risk increase your weight by 4.5 kg or more.
"This phenomenon was first noticed a few years ago, when Prozac was introduced on the market. Initially, weight gain were observed in clinical trials, because most of them lasted from 8 to 12 weeks, and weight gain was observed only at a long-term use of the drug. This is definitely one of the side effects of Prozac and other antidepressants, "says Norman Sussman, MD, psychiatrist, deputy dean of postgraduate medical programs of the medical School of New York University.
Lexapro and weight loss
Antidepressants are among the most controversial drugs of modern times. The main function of a medication - reducing the symptoms of depression, but to achieve this goal there is a variety of ways. Because some drugs have the side effect of an increase in body weight, and sudden weight loss.
Most often prescribed to combat depression, and these include: "Citalopram" "Fluvoxamine", "Escitalopram", "Paroxetine", "Fluoxetine". Tablets are characterized by small side effects, but not uniquely affect weight. While the receptors in the brain to adapt to the drug, the appetite may decrease, but after getting used to a craving for sweet foods can grow.
Tricyclic antidepressants were among the first to show efficacy against depression, but have many side effects. These pills do not affect the excess body weight, and appointed when other drugs do not relieve depressive symptoms.
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