Excitalopram (Lexapro)

SSRI antidepressant

Dosing

(mg/d): Depression (15-20), Anxiety disorders (20-30). Dose unknown in OCD so avoid there. 40mg citalopram = 20mg escitalopram (since citalopram is a 50/50 racemic mixture, 50% escitalopram)

Management

Side effects: apathy, sexual dysfunction, sleep disruption, nausea, restless legs, akathisia. Warning: osteopenia in post-menopausal women. Does not alter other med levels but its own levels are raised by 2C19 inhibitors like common proton pump inhibitors (ranitidine/Zantac). Raise dose by x1.3 if using with carbamazepine.

Preferred over citalopram. Good to pair with bupropion as does not interact with that. Good in elderly due to lack of drug interactions. Possibly more effective and better tolerated than other SSRIs.

EMR Text