One of the most “popular” antidepressants among doctors. According to our data, this medicine is one of the ten most frequently prescribed drugs by psychiatrists.
Escitalopram
is produced under many names: cipralex (considered the original, since it was the very first), elicea, esipi, escitalopram, selectra, lenuxin, miracitol, etc.
All of these are analogues, that is, drugs with the same active ingredient, but produced at different factories by different manufacturers.
The drug was obtained as a result of a “modification” of another antidepressant from the group of selective serotonin reuptake inhibitors (SSRIs) - citalopram.
The mechanism of action is associated with a decrease in the flow of the neurotransmitter serotonin back into the neuron after it has entered the intercellular space - the synapse.
The drug promotes the accumulation of serotonin in the synapse (the junction of neurons), and if the painful condition caused the depletion of serotonin, then long-term use of escitalopram leads to the restoration of serotonin metabolism and a decrease in the symptoms of the disease. The main effect is antidepressant and anti-anxiety.
Available in the form of film-coated tablets in a dosage of the active substance of 10 milligrams.
Indications for taking escitalopram
- Endogenous depression of mild to moderate severity.
- Panic attacks, panic disorder, generalized anxiety disorder, phobias.
- Organic anxiety and depressive disorders.
- Neuroses, neurasthenia, mixed anxiety and depressive disorder, somatoform disorders, psychosomatic diseases, prolonged reactive states (mental trauma, adaptation disorders).
- Alcohol and drug addiction, substance abuse.
The convenience of taking ecitalopram is that you do not need to adjust the dose (recommended - 10 mg / 1 tablet once a day
), rarely have side effects, according to psychiatrists it gives a positive effect in the vast majority of cases of use.
The disadvantages include the slow onset of the therapeutic effect over the course of a month, and a slight increase in anxiety in the first days of use (which is very inconvenient when treating panic attacks, phobias and anxiety disorders).
Compound
The antidepressant is based on escitalopram oxalate.
For better digestibility of the active ingredient, additives are used:
- croscarmellose sodium;
- prosolv SMCC90/HD90;
- magnesium stearate;
- talcum powder
Release form: film-coated tablets (composition: white opadry).
One package contains a certain amount of medicine: 10; 14; 20; 28; 56 pcs.
The most frequently asked questions about the use of escitalopram
Is escitalopram addictive?
The drug does not cause dependence. Those cases when painful symptoms went away while taking escitalopram, but returned after discontinuation of the drug, do not indicate the formation of addiction, but about too early cessation of treatment or insufficient therapy.
Can I take it on my own?
No. Only after prescription by a doctor.
Can a psychologist prescribe escitalopram?
No. Like any antidepressant, like any medicine, this drug can only be prescribed by a doctor - a person with a higher medical education, then completed specialization (internship or residency) and has a valid doctor’s certificate.
Psychiatrists are the most knowledgeable about the treatment of depression and anxiety disorders and the effects of antidepressants. But doctors of other specialties can also prescribe antidepressants. The psychologist does not have a medical education and therefore cannot make such appointments. Read more about the difference between a psychologist, psychotherapist and psychiatrist here.
How and where can I purchase it? What does this require?
It is sold in pharmacies. To purchase it you will need to present a prescription from a doctor.
Does escitalopram contribute to suicidal behavior?
There is no such data. The described isolated cases of suicide while taking this drug were explained by the fact that there were risks of suicide even before the start of treatment. Suicide was a consequence of illness (depression, psychosis), and not the effect of the drug.
Is it possible to drink alcohol during treatment with escitalopram?
Drinking alcohol neutralizes the therapeutic effect of the medicine and worsens the general condition of the brain. Therefore, drinking alcohol during treatment is not advisable.
How long to take escitalopram?
Treatment with this antidepressant takes several months. The therapeutic effect usually develops in the first 3 months of treatment; further use usually prevents the recurrence of symptoms.
If indicated, long-term use is possible. Even if there are no complaints about the condition during therapy with escitalopram, you need to see a doctor at least once every 2-3 months. The duration and regimen of administration is determined by the attending physician. On average it is about 6 months.
Is it possible to replace escitalopram with a similar drug with a different name during treatment?
This question often arises due to the large difference in price for the same drug, produced by different manufacturers and having a different name. As experience shows, no changes occur with such a change. But if such a question arises, it is best to consult your doctor.
What is better: the original drug Cipralex or its cheaper generic analogues?
According to the author of this material, there is no fundamental difference.
SELECTRA
Interaction
Monoamine oxidase inhibitors (MAOIs)
Serious adverse reactions may occur when taking SELECTRA and MAO inhibitors concomitantly, as well as when taking MAO inhibitors in patients who have recently stopped taking the drug. In such cases, serotonin syndrome may develop.
Escitalopram should not be administered concomitantly with MAO inhibitors. Escitalopram can be prescribed 14 days after stopping treatment with irreversible MAO inhibitors and at least 1 day after stopping treatment with the reversible MAO type A inhibitor, moclobemide. At least 7 days must pass after stopping escitalopram before treatment with non-selective MAO inhibitors can be started.
Serotonergic drugs
Concomitant use with serotonergic drugs (eg, tramadol, sumatriptan and other triptans) may lead to the development of serotonin syndrome.
Medicines that lower the seizure threshold
SELECTRA may lower the seizure threshold. Caution is required when co-administered with other drugs that lower the seizure threshold (tricyclic antidepressants, other SSRIs, antipsychotics (phenothiazines, thioxanthene and butyrophenone derivatives), mefloquine and tramadol).
Lithium, tryptophan
Escitalopram enhances the pharmacological effects of tryptophan (increased serotonergic effect) and the toxic effects of lithium preparations.
St. John's wort (Hypericum perforatum)
The simultaneous administration of escitalopram and drugs containing St. John's wort (Hypericum perforatum) may lead to an increase in the number of side effects.
Anticoagulants and other drugs that affect blood clotting
Bleeding disorders may occur when escitalopram is co-administered with oral anticoagulants and other drugs that affect blood clotting (for example, atypical antipsychotics and phenothiazines, most tricyclic antidepressants, acetylsalicylic acid and non-steroidal anti-inflammatory drugs, ticlopidine and dipyridamole). In such cases, monitoring of blood coagulation parameters is necessary.
Ethanol
Escitalopram does not interact pharmacodynamically or pharmacokinetically with ethanol. However, as with other psychotropic drugs, the simultaneous use of escitalopram and alcohol is not recommended.
Effect of other drugs on the pharmacokinetics of escitalopram
Co-administration with drugs that inhibit cytochrome CYP2C19 may increase plasma concentrations of escitalopram. Caution should be exercised when escitalopram is used concomitantly with similar drugs, such as omeprazole. A dose reduction of escitalopram may be required.
Caution should be exercised when high doses of escitalopram are administered concomitantly with high doses of cimetidine, which is a strong inhibitor of the cytochromes CYP2D6, CYP3A4 and CYP1A2.
Effect of escitalopram on the pharmacokinetics of other drugs
Escitalopram is an inhibitor of the CYP2D6 isoenzyme. Caution should be exercised when co-prescribing escitalopram and drugs metabolized by this isoenzyme and having a low therapeutic index, for example, flecainide, propafenone and metoprolol (in cases of use in heart failure) or drugs mainly metabolized through CYP2D6 and acting on the central nervous system , for example, antidepressants - desipramine, clomipramine, nortriptyline, or antipsychotics - risperidone, thioridazine, haloperidol. In these cases, dose adjustment may be required as the concentration of escitalopram in the blood plasma increases.
The simultaneous administration of escitalopram and desipramine or metoprolol leads to a twofold increase in the concentration of the latter two drugs, which should be taken into account when choosing doses.
Escitalopram may slightly inhibit the CYP2C19 isoenzyme. Therefore, caution is recommended when using escitalopram concomitantly with medicinal products metabolized by CYP2C19.
Side effects
It is prohibited to use an antidepressant on your own due to the presence of special instructions for the use of the drug and possible side effects that were recorded during the study of the drug.
The identified effects are classified according to vital systems:
- Gastrointestinal tract: dry mucous membranes, decreased appetite, nausea, stool disorders, vomiting.
- Central nervous system: physical weakness, sleep disturbance or drowsiness, dizziness, convulsions, trembling fingers, complications after taking medications that affect the metabolism of serotonin in the nervous system.
- Cardiovascular system: decreased blood pressure when changing body position due to insufficient blood flow to the brain.
- Endocrine system: spontaneous secretion of milk from the mammary glands (not associated with the lactation period), decreased secretion of antidiuretic hormone.
- Genitourinary system: decreased potency, weakened libido, anorgasmia, urinary retention, impaired ejaculation.
A rash, purpura, ecchymosis, and angioedema may appear on the surface of the skin after taking the tablets. An allergic reaction is also possible due to the body's sensitivity to the active substance.
Other side effects include:
- myalgia;
- sinusitis;
- hyponatremia;
- hyperthermia;
- increased sweating, etc.
Price
The cost of Selectra depends on the manufacturer and the number of tablets in the package ( 461-970 rubles for 28 pieces ).
Price in Moscow – 989 rubles (excluding delivery surcharge when ordering online). You can buy tablets in a pharmacy chain or online store.
The antidepressant is dispensed with a prescription in Latin, which complies with the rules for processing medical documents.
Analogs
You can replace Selectra with other means of similar action:
- Asipi (from 382 rub.);
- Escitalopram (from RUR 193);
- Elicea (from 536 rub.);
- Elicea Ku-tab (from 541 rub.);
- Escitalopram Canon (from RUR 265).
The same group with Selectra also includes more affordable antidepressants:
- Amitriptyline – 14.80 rubles;
- Apo-Fluoxetine – 26.60 rubles;
- Fluoxetine – 25.30 rubles;
- Amitriptyline Nycomed – 47.60 rub.
The privilege to select an analogue and make changes to the treatment regimen remains exclusively with the attending physician.
side effects during treatment ; this should be reported to your doctor immediately. There is no need to interrupt therapy; most symptoms disappear after 5-7 days. The duration of taking pills is sometimes six months, but thanks to the pharmacological properties of the active substance, it becomes possible to return to a full life.
Reviews from patients who took the drug
Tatyana Vladimirovna, 52 years old:
Doctors diagnosed me with panic attacks. At the initial stage of therapy, the state was terrible: apathy towards everything that was happening, children, grandchildren. Sharp changes in mood, unreasonable irritability and insomnia began to tire me and my loved ones with whom I live under the same roof. After the first month of taking Selectra, life began to take on some colors and make me happy with simple things - good weather, new purchases.
The impressive list of side effects passed me by.
Vitaly, 27 years old:
After the accident, he could not come to his senses for a long time until he fell into a depressive state. I went to the clinic to see a neurologist because of insomnia. The doctor referred me to a psychotherapist, who prescribed Selectra. The first days after starting the course of treatment were difficult, headaches appeared, bowel movements were disrupted, and potency decreased. But by the third week the condition stabilized, and no more side effects appeared. Sex life improved after the end of therapy.
Olga, 34 years old:
A month after taking the antidepressant, Selectra felt easier to perceive everything that was happening. Anxiety and irritability disappeared as if by hand. The doctor did not discontinue the drug after the condition improved; he recommended taking the pill for another couple of months to consolidate the effect.
I’ve been living a normal life for a year and a half now, enjoying every moment, and there have been no relapses.
