Escitalopram - Common brands: Cipralex

What escitalopram is for

Escitalopram can be used to treat mental health conditions such as:

• depression
• obsessive compulsive disorder (OCD)
• generalised anxiety disorder
• social anxiety disorder
• panic disorder

It's a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI).

It's thought to work by increasing the level of serotonin (a chemical in the brain linked to mood). When serotonin levels are normal, this may reduce stress levels and negative thoughts.

How to take escitalopram

Escitalopram comes as tablets you swallow, tablets you let dissolve in your mouth (orodispersible tablets) or liquid drops.

You usually take escitalopram once a day. How much you need to take depends on why you're taking it.

Your doctor may prescribe a low dose to start with and increase it after a few weeks. This reduces the chances of side effects.

It can take several weeks until your symptoms start to improve.

When taking escitalopram:

• swallow tablets whole, with a drink of water
• put orodispersible tablets on your tongue and let them dissolve, then swallow with a drink of water
• for liquid drops, turn the bottle upside down and count the correct number of drops into a glass of water (or orange or apple juice), stir and then drink
• you can take escitalopram with or without food

You may need to take escitalopram for a long time. For example, if you're taking it for depression, you'll probably need to keep taking it for 6 months or more.

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

If you miss a dose of escitalopram

If you forget to take a dose of citalopram, take it as soon as you remember, unless it's nearly time for your next dose.

If it's nearly time for your next dose, skip the dose you missed and take your next dose the next day as usual.

Do not take 2 doses to make up for a missed dose.

If you take too much escitalopram

Taking an extra dose of escitalopram can be dangerous.

How to stop taking escitalopram

Your doctor may suggest you stop taking escitalopram if you've been feeling better for some time.

But do not suddenly stop taking it because it may cause withdrawal symptoms.

Your doctor will gradually reduce your dose over several weeks or months. Always follow your doctor's advice.

Side effects of escitalopram

Like all medicines, escitalopram can cause side effects, although not everyone gets them.

Most side effects should ease after a couple of weeks as your body gets used to the medicine, but some can last longer.

Common side effects

Common side effects of escitalopram include:

• headaches
• feeling sick (nausea) and being sick (vomiting)
• sweating
• diarrhoea or constipation
• joint or muscle pain
• feeling dizzy, sleepy, anxious or restless
• weight changes, and changes in how hungry you feel
• problems sleeping
• sexual problems, such as low sex drive (loss of libido)

If you feel dizzy, sleepy or have blurred vision after taking escitalopram do not drive, ride a bike or use machinery until you no longer have these symptoms.

Serious side effects

Escitalopram can sometimes cause more serious side effects, although most of them are rare.

Possible serious side effects of escitalopram include:

• an allergic reaction (anaphylaxis) – causing symptoms such as a swollen throat or tongue, a raised, itchy rash and difficulty breathing
• serotonin syndrome – a rare but serious condition that causes a fast heartbeat, sweating, shaking, twitching muscles and feeling confused or agitated
• a rare but life-threatening condition that causes a fast, irregular heartbeat, light-headedness and fainting (torsades de pointes)
• internal bleeding, which you may notice if you have bruises, or blood in your pee, poo or vomit
• feeling very low and having suicidal thoughts

Who can and cannot take escitalopram

Most adults can take escitalopram, but it's not suitable for everyone.

For example, it may not be suitable if you have:

• had a serious side effect or allergic reaction to escitalopram or another antidepressant before
• heart rhythm problems
• a bleeding disorder (especially bleeding in the digestive system)
• kidney or liver problems
• diabetes
• epilepsy
• heart disease
• glaucoma
• had high moods caused by a mental health condition (mania) before

Before taking escitalopram, tell your doctor if you have any other medical conditions.

Breastfeeding and escitalopram

Tell your doctor if you're breastfeeding.

Escitalopram is sometimes used while breastfeeding, but it's best to check because the medicine can pass into your breast milk.

Your doctor may suggest you continue taking escitalopram if the benefits to you outweigh any possible risks to your baby, but they may suggest switching to a different antidepressant.

It's possible for breastfed babies to get side effects from escitalopram, so speak to a healthcare professional or call NHS 111 if you have any concerns about your baby.

Pregnancy and escitalopram

Tell your doctor if you're pregnant or you get pregnant while taking escitalopram.

Escitalopram can be used during pregnancy if needed. Your doctor will talk to you about the risks and benefits of taking it while you're pregnant.

If you need to take escitalopram while you're pregnant, your doctor will prescribe the lowest possible effective dose.

You'll also usually be advised to give birth in hospital so you and your baby can be closely monitored after you've given birth.

Find out more about taking escitalopram during pregnancy on the Bumps (Best Use of Medicines in Pregnancy) website

Taking escitalopram with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with escitalopram.

These include:

• antidepressants called monoamine oxidase inhibitors (MAOIs), such as moclobemide and selegiline
• medicines to treat heart rhythm problems
• anticoagulants, such as warfarin
• NSAIDs, such as aspirin and ibuprofen
• antihistamines
• medicines used to treat stomach ulcers
• the herbal supplement St John's wort

Before taking escitalopram, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Food, drink and alcohol with escitalopram

You can eat and drink normally when taking escitalopram.

It's best not to drink alcohol while taking escitalopram as it can increase the risk of side effects, such as making you feel more sleepy.