Escitalopram is a selective serotonin re-uptake inhibitor (SSRI) and the S-enantiomer of racemic citalopram. It is used to restore serotonergic function in the treatment of depression and anxiety. Escitalopram is approximately 150 times more potent than citalopram’s R-enantiomer and is responsible for the vast majority of citalopram’s clinical activity, with some evidence suggesting that the R-enantiomer of racemic citalopram actively dampens the activity of escitalopram rather than existing simply as an inactive enantiomer. Amongst SSRIs, escitalopram exerts the highest degree of selectivity for the serotonin transporter (SERT) relative to other off-targets which may explain its lower rates of adverse effects as compared to other agents in this class. Escitalopram also differentiates itself from other SSRIs via allosteric action on its target - this may be the mechanism responsible for its observed superior efficacy and faster onset compared to other SSRIs.
Escitalopram is indicated for the acute and maintenance treatment of major depressive disorder (MDD) in adults and pediatric patients 12 years old and older and for the acute treatment of generalized anxiety disorder (GAD) in adults and pediatric patients 7 years old and older. It is additionally indicated for symptomatic relief of obsessive-compulsive disorder (OCD) in Canada.
LSU Anxiety and Mood Disorders Clinic, New Orleans, Louisiana, United States
Sykehuset Innlandet HF, Reinsvoll, Oppland, Norway
Diakonihjemmets Hospital, Oslo, Norway
Ullevaal University Hospital, Oslo, Norway
Duke University Medical Center, Durham, North Carolina, United States
Max Planck Institute of Psychiatry, Munich, Germany
University of Nebraska Medical Center, Omaha, Nebraska, United States
Sanofi-Aventis Administrative Office, Bromma, Sweden
Dept OB/GYN, Mudd Professorship Suite, Philadelphia, Pennsylvania, United States
University of Ottawa, Institute of Mental Health Research, Ottawa, Ontario, Canada
New York State Psychiatric Institute, New York, New York, United States
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