Elodep 5 mg

Indications
Elodep is used to treat the following conditions:

• Major depressive episodes
• Panic disorder (with or without agoraphobia)
• Social anxiety disorder (social phobia)
• Generalized anxiety disorder
• Obsessive-compulsive disorder
  Use the medication as prescribed by a registered physician

Pharmacology
Escitalopram is an oral selective serotonin reuptake inhibitor (SSRI). It is the pure S-enantiomer of the racemic compound citalopram. Escitalopram is significantly more potent—at least 100 times stronger than the R-enantiomer in inhibiting serotonin (5-HT) reuptake. It shows no or very low affinity for other receptors, including serotonergic, adrenergic (alpha and beta), dopamine, histamine, muscarinic, and benzodiazepine receptors.

Dosage
Escitalopram is typically taken once daily, with or without food. The safety of doses exceeding 20 mg per day has not been established.

• Major depressive episodes: Start with 10 mg once daily. The dosage may be increased to a maximum of 20 mg depending on individual response. It may take 2-4 weeks to see an antidepressant effect. After symptoms resolve, treatment should continue for at least 6 months to consolidate the response.

• Panic disorder: Begin with 5 mg for the first week, then increase to 10 mg daily. The dose can be raised to a maximum of 20 mg daily, based on individual response. Optimal effectiveness is typically achieved after 3 months of treatment, which may continue for several months.

• Social anxiety disorder: Start with 10 mg once daily. Symptom relief may take 2-4 weeks. Based on response, the dose may be reduced to 5 mg or increased up to 20 mg daily. Long-term treatment for at least 12 weeks is recommended for consolidating the response. Treatment duration beyond 12 weeks may be considered based on the patient’s response to prevent relapse.

• Generalized anxiety disorder: Start with 10 mg once daily, with a potential increase to 20 mg daily depending on the individual’s response. Long-term use (up to 6 months) has been studied with a daily dose of 20 mg. Regular evaluation of treatment benefits and dosing is advised.

• Obsessive-compulsive disorder: Begin with 10 mg once daily. The dosage may be increased to a maximum of 20 mg based on individual response. OCD is a chronic condition, and patients should be treated for a sufficient period until symptoms resolve. Treatment duration should be periodically reassessed.

Use the medication as prescribed by a registered physician

Administration
Escitalopram should generally be taken once daily, either in the morning or evening, with or without food.
Use the medication as prescribed by a registered physician

Interaction
SSRIs like escitalopram should not be initiated until 2 weeks after stopping a monoamine oxidase inhibitor (MAOI). Likewise, an MAOI should not be started until at least one week after discontinuing escitalopram (2 weeks for paroxetine and sertraline; at least 5 weeks for fluoxetine).

Contraindications
Escitalopram is contraindicated in patients with known hypersensitivity to escitalopram, citalopram, or any of the drug’s inactive ingredients. It should not be taken concurrently with monoamine oxidase inhibitors (MAOIs) or pimozide.

Side Effects
Common side effects of SSRIs include gastrointestinal issues (such as nausea, vomiting, indigestion, abdominal pain, diarrhea, constipation), weight changes (anorexia with weight loss or increased appetite with weight gain), and hypersensitivity reactions (rash, urticaria, angioedema, anaphylaxis). Other possible side effects include dry mouth, nervousness, anxiety, headache, insomnia, tremors, dizziness, fatigue, hallucinations, sexual dysfunction, urinary retention, sweating, hypomania or mania, movement disorders, and visual disturbances.

Pregnancy & Lactation
Escitalopram should be used during pregnancy only if the potential benefits outweigh the risks. It is excreted in human breast milk, and the decision to continue nursing while taking escitalopram should be made based on the risk to the infant and the benefit to the mother.

Precautions & Warnings
Caution is advised when using SSRIs in patients with a history of epilepsy (especially if poorly controlled), those undergoing electroconvulsive therapy, or those with a history of mania, heart disease, diabetes, angle-closure glaucoma, bleeding disorders, or liver and kidney impairments. Special care is needed when using escitalopram with other drugs that increase bleeding risk.

Use in Special Populations

• Elderly patients (>65 years): Start with 5 mg once daily. If needed, the dosage may be increased to 10 mg daily.
• Children and adolescents (<18 years): Escitalopram should not be used in children or adolescents under the age of 18.
• Renal impairment: No dosage adjustment is needed for mild to moderate renal impairment. Caution is necessary for patients with severe renal impairment (creatinine clearance <30 ml/min).
• Hepatic impairment: Begin with 5 mg daily for the first two weeks for patients with mild to moderate liver impairment. Depending on response, the dose may be increased to 10 mg daily. For severe liver impairment, special caution is advised with dose titration.

Discontinuation
When discontinuing escitalopram, the dosage should be gradually reduced over a period of at least one to two weeks to minimize withdrawal symptoms. If intolerable symptoms occur, resuming the previous dose may be considered, followed by a more gradual taper.

Overdose Effects
Symptoms of overdose may include central nervous system effects (such as dizziness, tremor, agitation, serotonin syndrome, convulsions, and coma), gastrointestinal symptoms (nausea, vomiting), cardiovascular issues (hypotension, tachycardia, QT prolongation, arrhythmias), and electrolyte imbalances (e.g., hypokalemia, hyponatremia).
Management involves supportive care, including airway management, oxygenation, gastric lavage, and cardiac monitoring.

Therapeutic Class
SSRIs & related antidepressants

Storage Conditions
Store below 30°C, protected from light and moisture. Keep out of the reach of children.

Pack Image of Elodep 5 mg Tablet.