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Escitalopram (Lexapro) is an antidepressant medication used to treat various mental/mood disorders. While beneficial in managing symptoms, it is crucial to be aware of potential risks and precautions associated with its use. Below is a summary of important safety information and warnings to consider:

• Worsening Depression and Suicidal Thoughts: Some individuals, particularly those under 25, may experience worsening depression, unusual behavior, or suicidal thoughts, especially when starting the medication or changing dosage. It is vital to monitor for symptoms like anxiety, panic attacks, irritability, and restlessness. Seek medical attention immediately if these occur.

• Serotonin Syndrome: A rare but serious condition, serotonin syndrome, can occur when taking escitalopram with other medications that increase serotonin levels. Symptoms include rapid heart rate, sweating, muscle stiffness, fever, and confusion. If these symptoms appear, contact a healthcare provider immediately.

• Discontinuation Symptoms: Stopping escitalopram abruptly may lead to withdrawal symptoms such as nausea, anxiety, flu-like symptoms, and dizziness. Consult your healthcare provider for guidance on safely tapering the dosage.

• Bleeding Risk: Escitalopram may increase the risk of bleeding, especially if taken with blood-thinning medications. Look out for unusual bruising, blood in stools or urine, or bleeding from the nose or gums, and seek medical help if these occur.

• Bipolar Disorder: Escitalopram is not recommended for use alone in bipolar disorder, as it may trigger manic episodes. Discuss any history or risk of bipolar disorder with your healthcare provider before starting treatment.

• Glaucoma: The medication can worsen angle-closure glaucoma. Regular eye exams are recommended, and any vision changes should be reported to your healthcare provider.

• Heart Rhythm Issues (QT Prolongation): Escitalopram can affect heart rhythm, posing serious risks. Those with heart problems or taking medications affecting heart rhythm should be closely monitored. Contact emergency services if experiencing chest pain, faintness, or shortness of breath.

• Low Blood Sodium Levels: This medication may cause low sodium levels in the blood, particularly in older adults or those on diuretics. Symptoms like confusion, headache, or memory problems require immediate medical attention.

• Sexual Side Effects: Some individuals may experience sexual side effects, including reduced libido and difficulty achieving orgasm. Discuss any concerns with your prescriber.

Contraindications: Do not use escitalopram if you have taken MAOIs, linezolid, or methylene blue recently, are allergic to citalopram, or are taking pimozide. Always consult with a healthcare provider before beginning treatment.

Common side effects:

• Headache
• Nausea
• Ejaculation problems
• Sleepiness
• Trouble sleeping
• Dry mouth
• Diarrhea
• Tiredness
• Dizziness
• Sweating
• Low appetite
• Indigestion
• Constipation
• Lower sexual drive
• Difficulty having an orgasm

• Flu-like symptoms

  Serious side effects:

• Suicidal thoughts or behaviors
• Serotonin syndrome
• Abnormal heart rhythms (QT prolongation)
• Severe bleeding
• Low blood sodium levels
• Painful or prolonged erection
• Serious allergic reactions

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors (isocarboxazid, Linezolid, Metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, Rasagiline, safinamide, Selegiline, Tranylcypromine)
• Other drugs that increase serotonin (SSRIs like Fluoxetine, SNRIs like Venlafaxine, street drugs like MDMA, St. John's Wort)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Antiplatelet drugs (Clopidogrel), NSAIDs (Ibuprofen, Naproxen), blood thinners (Dabigatran, Warfarin)
• Aspirin
• Alcohol, marijuana (cannabis), antihistamines (Cetirizine, diphenhydramine), sleep or anxiety drugs (Alprazolam, Diazepam, Zolpidem), muscle relaxants, opioid pain relievers (codeine)
• Drugs that may affect heart rhythm (Amiodarone, Pimozide, procainamide, quinidine, Sotalol)
• Citalopram