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Author: Admin | 2025-04-28
In Canada, Lundbeck's Cipralex comes in 5, 10, 15, 20 mg tablets. Official US information: Description at PubMed https://pubmed.ncbi.nlm.nih.gov/17375980/ FDA documentation, including history of warnings, https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021323s052,021365s037lbl.pdf Prescribing information: FDA prescribing information: https://www.drugs.com/pro/lexapro.html The drug half-life is 27–32 hours http://www.ncbi.nlm.nih.gov/pubmed/17375980 From http://www.drugs.com/pro/escitalopram-tablets.html The liver enzymes represented by P450 CYP3A4 and CYP2C19 are the primary avenues of metabolization. Quote Following a single oral dose (20 mg tablet) of escitalopram, peak blood levels occur at about 5 hours. Absorption of escitalopram is not affected by food. From the FDA-mandated US package insert (PDF): Quote Discontinuation of Treatment with Lexapro During marketing of Lexapro and other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms. Patients should be monitored for these symptoms when discontinuing treatment with Lexapro. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate [see Dosage and Administration (2.4)]. Special considerationsA significant characteristic of Lexapro is that milligram for milligram, escitalopram is stronger than other SSRIs. Chemically, Lexapro (escitalopram) is a variation of Celexa (citalopram); the molecule was re-engineered to be patentable as Celexa's patent was about to expire. The streamlined molecule is a more potent SSRI, 2 to 4 times stronger than others. (Wikipedia has a good explanation of this at https://secure.wikimedia.org/wikipedia/en/wiki/Escitalopram.) Aronson, J. K. (Ed.). (2006). Citalopram and escitalopram. In Meyler’s Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions (Fifteenth Edition) (pp. 383–387). Elsevier. https://doi.org/10.1016/B0-44-451005-2/00045-0 Quote Escitalopram oxalate is the S-enantiomer of citalopram (5). The therapeutic activity of citalopram resides in the S-isomer and escitalopram binds with high affinity to the human serotonin transporter; R-citalopram is about 30-fold less potent. The half-life of escitalopram is 27–32 hours. ... Therefore, initial dosing of escitalopram should be half that of citalopram, 10mg vs 20mg respectively: https://psychopharmacologyinstitute.com/publication/citalopram-and-escitalopram-a-summary-of-key-differences-and-similarities-2179 Quote The dosage range for depression for citalopram is 20-40 mg/day, this
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