Meliva

• Major Depressive Episodes: Used for the treatment of depression.
• Panic Disorder: Used for panic disorder with or without agoraphobia.
• Social Anxiety Disorder: Used for social phobia.
• Generalised Anxiety Disorder: Used for generalized anxiety disorder.
• Obsessive-Compulsive Disorder: Used for OCD.

Escitalopram is an orally administered selective serotonin reuptake inhibitor (SSRI). Escitalopram is the pure S-enantiomer of the racemic bicyclic phthalate derivative citalopram. Escitalopram is at least 100 fold more potent than the R-enantiomer with respect to inhibition of 5-HT reuptake. Escitalopram has no or very low affinity for serotonergic or other receptors.

Adult Dose:

• Anxiety, Depression, OCD: 10 mg once daily; increase after at least 1 week if needed; Max: 20 mg/day.
• Panic Disorder: Initial: 5 mg once daily; increase to 10 mg/day after 1 week; Max: 20 mg/day.
• Social Anxiety Disorder: 10 mg once daily; may decrease to 5 mg or increase to 20 mg/day.
• Elderly (>65 years): Initial: 5 mg/day; may increase to 10 mg/day if needed.
• Hepatic impairment (mild-moderate): Initial: 5 mg/day for 2 weeks; may increase to 10 mg/day if needed.

Child Dose (≥12 years): 10 mg PO qDay; may increase after 3 weeks; Max: 20 mg/day.

Common Side Effects:

• Anorgasmia (decreased orgasm in women)
• Decreased libido
• Delayed ejaculation
• Fatigue
• Increased sweating
• Insomnia (difficulty in sleeping)
• Nausea
• Sleepiness
• Headache
• Dizziness
• Dry mouth

Others: Anxiety, akathisia, decreased appetite/weight loss, seizures, serotonin syndrome, QT prolongation.

Use in Pregnancy: Escitalopram may be unsafe to use during pregnancy. Animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and any potential risks before prescribing.

Precautions:

• Escitalopram may affect your ability to drive.
• Take it in the morning (can keep you awake if taken late at night).
• Talk to your doctor if you notice sudden mood changes or develop suicidal thoughts.
• Lower chance of causing sexual dysfunction than other similar medications.
• Addiction or dependence potential is very less.
• Do not stop taking suddenly without talking to your doctor (withdrawal symptoms).
• Inform doctor if you have epilepsy, diabetes, liver/kidney disease, heart problems.
• Inform doctor if taking MAO inhibitors.

Overdose:

Symptoms: CNS (dizziness, tremor, agitation, serotonin syndrome, convulsion, coma), GI (nausea/vomiting), Cardiovascular (hypotension, tachycardia, QT prolongation, arrhythmia), Electrolyte (hypokalemia, hyponatremia).

Management: No specific antidote. Establish airway, ensure oxygenation. Gastric lavage and activated charcoal. Cardiac monitoring recommended.

Storage: Store below 30°C, protect from light and moisture. Keep out of reach of children.