Escitalopram 5 mg (Escitalopram oxalate)

Adult administration

The safety of doses exceeding 20mg per day has not been established. This medication is administered once daily in the morning or evening, with or without food. 1) Adults (1) Major depressive disorder: The usual dose is 10mg once daily. Depending on the patient’s response, the dose may be increased to a maximum of 20mg per day. If increasing the dose of this medication to 20mg, increase it at intervals of at least 1 week. In general, 2-4 weeks are needed for antidepressant effects to appear. Even after symptoms have resolved, medication treatment for at least 6 months is needed to ensure the treatment 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 the dose to 10mg per day. Depending on the patient’s response, the dose may be increased to a maximum of 20mg per day. The maximum effect appears after approximately 3 months. The safety and efficacy of long-term administration of this medication 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. In general, 2-4 weeks are needed for symptoms to improve. Thereafter, depending on the patient’s response, the dose may be reduced to 5mg per day or increased to a maximum of 20mg per day. Social anxiety disorder is a condition with a chronic course, and continued treatment for 12 weeks is recommended to ensure the treatment effect. Long-term treatment in patients who responded was studied for 6 months, and should be considered for each patient individually 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 treatment should be given only when social anxiety disorder significantly interferes with occupational and social activities. Drug treatment has not been compared with cognitive behavioral therapy. Drug treatment is one part of an overall treatment strategy. (4) Generalized anxiety disorder: The initial dose is 10mg once daily. Depending on the patient’s response, the dose may be increased to a maximum of 20mg per day after at least 1 week of treatment. A long-term administration study was conducted in patients who responded to 12 weeks of open-label treatment, with 20mg per day administered for at least 6 months. The physician should regularly reassess the usefulness of long-term treatment with this medication for each patient. (5) Obsessive-compulsive disorder: The usual dose is 10mg once daily. Depending on the patient’s response, the dose may be increased to a maximum of 20mg per day. A long-term administration study was conducted in patients who responded to 16 weeks of open-label treatment, with 10mg or 20mg per day administered for at least 24 weeks. Obsessive-compulsive disorder is a chronic condition; treatment should continue for a sufficient period to ensure recovery from symptoms. If this medication 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 for 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. Depending on the patient’s response, the dose may be increased to 10mg per day. 4) Discontinuation of treatment When discontinuing this medication, 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 a psychiatric disorder and starting treatment with this medication, an interval of at least 14 days must be allowed. Conversely, when starting an MAO inhibitor to treat a psychiatric disorder, at least 14 days must have elapsed after discontinuing this medication. 6) Other MAO inhibitors, such as linezolid or methylene blue Patients receiving linezolid or intravenous methylene blue should not start treatment with this medication because of the increased risk of serotonin syndrome. For patients requiring more urgent treatment of a psychiatric condition, including hospitalization and other interventional procedures, administration should be considered. It may be necessary to urgently administer linezolid or intravenous methylene blue to a patient already receiving this medication. If no alternative to linezolid or intravenous methylene blue is available, and the benefits of treatment with linezolid or intravenous methylene blue are judged to outweigh the risk of serotonin syndrome for a particular patient, this medication may be discontinued immediately and linezolid or intravenous methylene blue administered. The patient 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 occurs first. Treatment with this medication may be resumed 24 hours after the last dose of linezolid or intravenous methylene blue. The risks associated with administration of methylene blue by non-intravenous routes (oral tablets or local injection) or intravenous administration of this medication at doses of 1mg/kg or less are unclear. Nevertheless, clinicians should be aware of the possibility of emergency symptoms of serotonin syndrome with these uses.

This drug is an antidepressant used in the treatment of psychiatric disorders such as major depression. This drug may increase the risk of suicidal thoughts or behaviors in children, adolescents, and young adults aged 18 to 24, hence extreme caution is advised when prescribing it to this age group. This medication should not be taken with certain drugs, particularly monoamine oxidase inhibitors (MAOIs), Pimavanserin, and drugs that may prolong the QT interval, as this can lead to serious side effects. Patients with closed-angle glaucoma or a history of glaucoma should be cautious due to the potential increase in intraocular pressure caused by the mydriatic effect of this medication. During the first 1-2 weeks of treatment, various side effects such as anxiety, insomnia, tremors, nausea, and headache may occur, which tend to subside over time. While on this medication, it is crucial to closely monitor for worsening depression symptoms, suicidal thoughts, aggression, or abnormal behavioral changes, and family or caregivers of the patient should also pay attention. Sudden discontinuation of this drug may result in withdrawal symptoms such as dizziness, anxiety, and sleep disturbances; therefore, it is important to taper the dosage gradually under the guidance of a healthcare professional when stopping treatment. This medication can affect the heart and may prolong the QT interval, so patients with heart conditions or arrhythmias should consult a doctor before use. For pregnant or breastfeeding women, this medication may impact the newborn, so consultation with a physician is required before use. Elderly patients should start at a lower dose than the usual adult dose, and side effects should be carefully monitored during treatment. It is advisable to avoid alcohol consumption while taking this medication, and patients should inform their doctor or pharmacist if they are taking any other medications due to potential interactions. In case of an overdose, symptoms such as central nervous system symptoms, gastrointestinal symptoms, and cardiovascular abnormalities may occur, and immediate medical attention is required. This medication is not recommended for use in children and adolescents as its safety and efficacy have not been established. Store this medication out of reach of children and avoid transferring it to another container.

Thrombocytopenia, anaphylactic reaction, inappropriate secretion of antidiuretic hormone, hyperprolactinemia, decreased appetite, increased appetite, weight gain, weight loss, hyponatremia, loss of appetite, anxiety, restlessness, abnormal dreams, decreased libido, sexual dysfunction, bruxism, agitation, irritability, panic attack, confusional state, aggression, depersonalization, hallucination, mania, suicidal thoughts, suicidal behavior, insomnia, drowsiness, dizziness, perceptual disturbances, tremors, taste disorders, sleep disturbances, syncope, serotonin syndrome, movement disorders, motor disturbances, seizures, psychomotor agitation, akathisia, mydriasis, visual impairment, tinnitus, tachycardia, bradycardia, QT interval prolongation, polymorphic ventricular tachycardia, ventricular arrhythmia, orthostatic hypotension, sinusitis, yawning, nosebleed, nausea, diarrhea, constipation, vomiting, dry mouth, gastrointestinal bleeding, hepatitis, abnormal liver function tests, increased sweating, urticaria, hair loss, rash, itching, petechiae, angioedema, arthralgia, myalgia, rhabdomyolysis, urinary retention, ejaculation disorders, erectile dysfunction, uterine bleeding, menorrhagia, galactorrhea, postpartum hemorrhage, priapism, fatigue, fever, edema, headache, dry mouth, abdominal pain, dyspepsia, enteritis, sensory disturbances, cough, asthma, dyspnea, fracture, palpitations, hypertension, paralysis, extrapyramidal disorder, migraine, chest pain, tremor, dry mouth, frequent urination, sedation, heartburn, anxiety, visual hallucinations, retrograde amnesia, epileptic seizures, mania, suicide, akathisia, hyponatremia, bleeding, serotonin syndrome, withdrawal symptoms, dizziness, sleep disturbances, anxiety, tremors, confusion, sweating, headache, diarrhea, palpitations, emotional instability, hypersensitivity, visual impairment, QT interval prolongation, sexual dysfunction

This medication should be stored in a container that protects from light and air, and it is safely stored at room temperature between 1 degree and 30 degrees Celsius. Such storage helps maintain the effectiveness and prevents degradation of the medication.

Appearance

White round film-coated tablet

Package unit

30 tablets/bottle, 100 tablets/bottle