Escitalopram

What is escitalopram?

Escitalopram is a medication that works by increasing levels of a chemical in the brain called serotonin. It belongs to a class of medications called selective serotonin reuptake inhibitors (SSRIs). This medication is used to treat conditions such as depression, generalized anxiety, and social anxiety disorders.

You may hear escitalopram called by its brand name, Cipralex.

Escitalopram comes in an oral tablet form and as disintegrating tablets.

Before giving escitalopram

Tell your child's health-care provider if your child:

• has an allergy to escitalopram or other medicines
• is taking any of these medications: pimozide, monoamine oxidase inhibitors (MAOIs)

Talk with your child's health-care provider if your child has any of the following conditions. Precautions may need to be taken with this medicine if your child has:

• thoughts of suicide
• bipolar disorder
• history of seizures
• liver or kidney disease — the dose of escitalopram may need to be adjusted
• heart problems

How to give escitalopram

Follow these instructions when giving your child escitalopram:

• Give escitalopram exactly as your child's health-care provider tells you, even if your child seems well.
• Talk to your child's health-care provider before you stop giving escitalopram for any reason. They may want to slowly decrease the dose of escitalopram before stopping to prevent withdrawal symptoms (such as nausea, restlessness, trouble sleeping, sweating, dizziness, pins and needles feeling in hands or feet).
• Give escitalopram at the same time every day.
• You can give your child escitalopram with or without food. You can give it with food if it causes an upset stomach.
• If your child has a feeding tube, escitalopram can be crushed into a fine powder and mixed with about 10 mL of drinkable water and given into the feeding tube.
• Be sure to flush the tube before and after escitalopram is given.

What should you do if your child misses a dose?

• Give the missed dose as soon as you remember.
• If it is almost time for the next dose, skip the missed dose. Give the next dose at the regular time.
• Do not give your child two doses to make up for one missed dose.

How long does this medicine take to work?

• Your child may start to feel better a few weeks after starting this medicine.
• It may take about six to eight weeks to see the full effect of escitalopram.

Your child may have some of these side effects while they take escitalopram. Check with your child's health-care provider if your child continues to have any of these side effects and they do not go away or they bother your child:

• Unusual tiredness, sleepiness, weakness or difficulty thinking clearly: Have your child avoid tasks that require alertness until you see how this medicine affects them.
• Feeling nervous, excitable, irritable or restless
• Headache
• Dizziness
• Decrease in sexual desire
• Dry mouth: If your child is able to, sucking on a hard candy or ice chips may help.
• Difficulty sleeping: Giving this medicine in the morning may help.
• Nausea, vomiting (throwing up) or diarrhea (loose, watery stools), which can contribute to weight loss: Taking the medicine with food or eating small and frequent meals may help prevent this side effect.
• Weight gain: Encouraging healthy meals that are low in fat, low in sugar and high in fibre may help.

Most of the following side effects are not common, but they may be a sign of a serious problem. Call your child's health-care provider right away or take your child to the Emergency Department if your child has any of these side effects:

• High fever, excessive sweating, confusion, shivering/shaking
• Seizures or convulsions
• Unusual behaviour: Rarely, escitalopram may cause behaviour changes such as increased agitation, hostility or thoughts of self-harm or harm to others. If this happens, call your child's health-care provider immediately but do not stop the escitalopram on your own.
• Signs of an allergic reaction to escitalopram: Swelling of the face, tongue or lips; rash or itchy skin; shortness of breath; sudden trouble swallowing or breathing.

What safety measures should you take when your child is using this medicine?

• This medication may cause your child to be less alert. Watch your child's activities closely until you see how escitalopram affects them. You may also have your child avoid tasks that require alertness, such as riding a bicycle, rollerblading and contact sports during the start of their treatment with escitalopram.
• Keep all appointments with the health-care provider to have your child checked regularly.
• It is important to tell your child's health-care provider if your child takes any other medications (prescription, over the counter or herbal), including:
• lithium
• St. John's Wort
• other antidepressants (such as SSRIs like fluoxetine and sertraline, and MAO-Is like selegiline)
• tryptophan
• pain medications in the opioids class (such as tramadol, fentanyl, morphine, hydromorphone, methadone, etc.)
• migraine medications in the triptan class (such as sumatriptan or rizatriptan)
• linezolid
• certain heart medications used to treat heart rhythm problems (such as digoxin, amiodarone, flecainide, sotalol, etc.)
• anti-fungal medications (such as ketoconazole, fluconazole)
• cough and cold medicines containing dextromethorphan
• medications that may affect blood clotting (such as warfarin, dabigatran, apixaban, rivaroxaban, Aspirin (ASA (acetylsalicylic acid)), ibuprofen, etc.)
• Alcohol may increase the side effects experienced from escitalopram, such as sleepiness or dizziness. It is best to ensure your child does not consume any alcohol or recreational drugs while taking escitalopram.

What other important information should you know?

Keep a list of all medications your child is on and show the list to their health-care providers.

Do not share your child's medicine with others and do not give anyone else's medicine to your child.

Make sure you always have enough escitalopram to last through weekends, holidays and vacations. Call your pharmacy at least two business days before your child runs out of medicine to order refills.

Keep all appointments at the clinic or doctor's office so that the health-care provider can check your child's reaction to escitalopram.

Keep escitalopram at room temperature in a cool, dry place away from sunlight. Do NOT store it in the bathroom or kitchen.

Do not keep any medicines that are out of date. Check with your pharmacist about the best way to throw away outdated or leftover medicines.

Keep escitalopram out of your child’s sight and reach and locked up in a safe place. If your child takes too much escitalopram, call your local Poison Information Centre at one of these numbers. These calls are free. 

• Call 1-844 POISON-X, or 1-844-764-7669, from anywhere in Canada except Quebec.
• Call 1-800-463-5060 if you live in Quebec.