Citalopram (Escitalopram Oxalate) Tablets

Adult dosage

The safety of doses exceeding 20mg per day has not been established. This drug is administered once daily in the morning or evening, regardless of meals. 1) Adults (1) Major depressive disorder: The usual dose is 10mg once daily. The dose may be increased to a maximum of 20mg per day according to the patient's response. If the dose is to be increased to 20mg, it should be increased at intervals of at least 1 week. Generally, 2-4 weeks are required for the effects of antidepressants to become apparent. Even after symptoms have resolved, drug therapy for at least 6 months is required to ensure a therapeutic effect. (2) Panic disorder with or without agoraphobia: It is recommended to administer an initial dose of 5mg per day for 1 week, then increase it to 10mg per day. The dose may be increased to a maximum of 20mg per day according to the patient's response. The maximum effect appears after approximately 3 months. The safety and efficacy of long-term administration of this drug for more than 10 weeks in the treatment of panic disorder have not been systematically studied. The physician should periodically reassess each patient to determine the need for continued treatment. (3) Social anxiety disorder: The usual dose is 10mg once daily. Generally, 2-4 weeks are required for symptoms to improve. Thereafter, the dose may be reduced to 5mg per day or increased to a maximum of 20mg per day according to the patient's response. Social anxiety disorder is a condition with a chronic course, and continued treatment for 12 weeks is recommended to ensure a therapeutic effect. Long-term treatment in patients who responded was studied for 6 months, and should be considered for each patient to prevent relapse. The usefulness of long-term treatment should be reassessed regularly. Social anxiety disorder is a well-defined diagnostic term for a specific disorder and should not be confused with excessive shyness. Drug therapy should be used only when social anxiety disorder significantly interferes with occupational and social activities. A comparison of drug therapy with cognitive behavioral therapy has not been evaluated. Drug therapy is one part of an overall treatment strategy. (4) Generalized anxiety disorder: The initial dose is 10mg once daily. The dose may be increased to a maximum of 20mg per day according to the patient's response after treatment for at least 1 week. A long-term study was conducted in patients who responded to 12 weeks of open-label treatment, in which 20mg per day was administered for at least 6 months. The physician should regularly reassess the usefulness of long-term treatment with this drug for each patient. (5) Obsessive-compulsive disorder: The usual dose is 10mg once daily. The dose may be increased to a maximum of 20mg per day according to the patient's response. A long-term study was conducted in patients who responded to 16 weeks of open-label treatment, in which 10mg or 20mg per day was administered for at least 24 weeks. Obsessive-compulsive disorder is a chronic disease; this drug should be administered for a sufficient period to ensure recovery from symptoms. If this drug is administered long term, its usefulness and dosage should be regularly reassessed for each patient. 2) Patients with renal impairment No dosage adjustment is necessary in patients with mild or moderate renal impairment. Caution should be exercised in patients with severe renal impairment (CLCR < 30㎖/min). 3) Patients with hepatic impairment An initial dose of 5mg per day for the first 2 weeks is recommended. The dose may be increased to 10mg per day according to the patient's response. 4) Discontinuation of treatment When discontinuing this drug, the dose should be gradually reduced over at least 1-2 weeks to avoid the possibility of withdrawal symptoms. 5) Switching from MAO inhibitors used to treat psychiatric disorders When discontinuing an MAO inhibitor used to treat psychiatric disorders and starting treatment with this drug, an interval of at least 14 days should be allowed. Conversely, when starting an MAO inhibitor to treat psychiatric disorders, at least 14 days must have elapsed after discontinuation of this drug. 6) Other MAO inhibitors such as linezolid or methylene blue Patients receiving linezolid or intravenous methylene blue should not start this drug because of the increased risk of serotonin syndrome. For patients requiring treatment for a more urgent psychiatric condition, including hospitalization, or other urgent interventions, administration should be considered. It may be necessary to urgently administer linezolid or intravenous methylene blue to a patient already receiving this drug. If there is no alternative to linezolid or intravenous methylene blue and the benefits of treatment with linezolid or intravenous methylene blue are judged to outweigh the risk of serotonin syndrome in a particular patient, this drug may be discontinued immediately and linezolid or intravenous methylene blue administered. Patients should be monitored for symptoms of serotonin syndrome for 2 weeks after administration of linezolid or intravenous methylene blue, or until 24 hours after the last dose, whichever comes first. Treatment with this drug may be restarted 24 hours after the last dose of linezolid or intravenous methylene blue. The risk associated with administration of methylene blue by non-intravenous routes (oral tablets or local injection) or intravenous administration of this drug at doses of 1mg/kg or less is unclear. Nevertheless, clinicians should be aware of the possibility of emergency symptoms of serotonin syndrome with these uses.

This medication is an antidepressant used for the treatment of psychiatric conditions such as major depression. There may be an increased risk of suicidal thoughts or behavior in children, adolescents, and young adults (ages 18-24), therefore doctors should prescribe it cautiously in these populations. There is no increased risk of suicide in adults aged 25 and older, and the risk tends to decrease in those 65 and older. During treatment, patient behavior should be closely monitored, and family or guardians should also closely observe the patient's condition. This medication should not be used in conjunction with certain drugs, particularly MAO inhibitors, as this increases the risk of serious side effects such as serotonin syndrome. It should also not be administered to patients with hypersensitivity to this medication, certain heart conditions, or those at risk of QT interval prolongation. Caution is warranted in patients with closed-angle glaucoma or a history of glaucoma, as this medication may dilate the pupils and increase intraocular pressure. Various side effects, such as anxiety, insomnia, dizziness, nausea, weight changes, and sexual dysfunction may occur during the first 1-2 weeks of administration but often diminish over time. Rarely, severe psychiatric symptoms such as suicidal thoughts, aggression, and hallucinations may occur, necessitating vigilance. Abrupt discontinuation of this medication may result in withdrawal symptoms like dizziness, anxiety, and sleep disturbances, hence the dosage should be gradually reduced according to the doctor’s instructions. Patients with heart disorders or those at risk of QT interval prolongation should have an ECG before starting this medication and consult their doctor immediately if any abnormal signs occur during therapy. It's important to avoid using this medication particularly in late pregnancy due to potential impacts on newborns and to stop breastfeeding while undergoing treatment since the drug can be passed through breast milk. It is advisable to avoid alcohol during treatment and inform healthcare providers about any other medications being taken due to significant drug interactions. Elderly patients should start at a lower dose compared to adults, and those with a history of epilepsy or mania should use this medication with special caution. Caution is advised when driving or operating machinery, as this medication may affect mental function. Overdose may manifest with central nervous system, cardiovascular, and gastrointestinal symptoms, requiring immediate emergency treatment. The safety and efficacy of this medication have not been established in children.

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This medication is sensitive to light and should be kept in a container that protects it from light. Additionally, it should be stored at a temperature between 1 and 30 degrees Celsius for optimal efficacy.

Appearance

White oval film-coated tablets

Package unit

30 tablets/bottle, 300 tablets/bottle