What time of day should you take lexapro: Uses, Side Effects and Dosage
Uses, Side Effects and Dosage
Prozac (fluoxetine) is a type of medication used to treat depression and depressive symptoms. It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRI). SSRIs are also used to treat anxiety disorders including panic disorder, bulimia, obsessive-compulsive disorder, among other conditions.
Prozac is also available in a generic formulation called fluoxetine HCL. It is available as a capsule, delayed-release capsule, tablet, and a solution.
The FDA approves Prozac for several mental illnesses and it is use off-label for several conditions.
Major Depressive Disorder
Major depressive disorder (MDD) is a mood disorder characterized by persistent and severe feelings of sadness and despair accompanied by a variety of other emotional, physical, and behavioral changes.
Obsessive-compulsive disorder (OCD) is a condition, that occurs when a person experiences unwanted and recurrent thoughts. They typically also experience compulsions which are repetitive behaviors intended to help them deal with their obsessive thoughts.
Bulimia is an eating disorder characterized by excessive eating (binge) usually followed by extreme measures such as fasting or inducing vomit to prevent weight gain (purge).
A person living with panic disorder will often experience sudden episodes of intense fear which they have no control over accompanied by a variety of physical and emotional symptoms.
Prozac in combination with Zyprexa (olanzapine) has an indication for treating treatment-resistant depression.
Acute Depressive Episodes Associated With Bipolar 1 Disorder
The same Prozac/Zyprexa combination also has an indication for people who have depressive episodes as a result of bipolar 1 disorder.
Premenstrual Dysphoric Disorder (PMDD)
Prozac is sometimes used to treat women who experience severe depressive symptoms just before their menstrual period begins.
Even though they aren’t approved by the FDA , Prozac is sometimes used off-label to alleviate symptoms of the following conditions:
- Borderline personality disorder
- Generalized anxiety disorder (GAD)
- Premature ejaculation
- Post-traumatic stress disorder
Before taking Prozac talk through the list of active and inactive ingredients with your doctor to ensure that you aren’t allergic to any ingredients in the medication.
Signs of an allergic reaction include rash, difficulty breathing and swelling of the face, tongue, or throat. If you suspect that you’re having an allergic reaction, get medical help immediately.
It’s a good rule of thumb to disclose to your doctor any other medication, vitamins, and supplements you might be taking to make sure that they don’t interact with the medication being prescribed to you.
If you have a history of any other medical conditions, especially liver disease, kidney disease, diabetes, and other mental health conditions you should also discuss this with your doctor.
Precautions and Contraindications
Prozac is prescribed with caution to pregnant women. Women in their third trimester of pregnancy who are using Prozac may experience adverse effects in their babies when the baby is born.
If you become pregnant while already on Prozac disclose this to your doctor to figure out the next steps. If you are breastfeeding, discuss the risks and benefits of Prozac use with your doctor.
You shouldn’t discontinue Prozac without consulting your doctor as this might worsen your symptoms or cause a relapse. If your doctor asks you to discontinue Prozac suddenly, you might experience withdrawal symptoms like nausea and insomnia, although given Prozac’s long half-life, this is less common than with other antidepressants.
Prozac is prescribed by a doctor who will recommend a dosage for your particular condition based on your medical history, tolerance to the drug, severity of your symptoms, and any other factors they might consider relevant.
However, the manufacturer of this medication typically recommends the following doses for these conditions.
- Major Depressive Disorder: The starting dose is usually 20 milligrams (mg) a day, typically taking in the morning. Your doctor might increase your doses if there are no significant improvements in your symptoms weeks after you start.
- Obsessive-Compulsive Disorder: Adults are typically advised to take 20 mg a day, taken in the morning to start, but it is often raised to 60 mg to 80 mg a day.
- Bulimia: 60 mg a day taken in the morning is the typical recommended dosage in the treatment of bulimia, although this will be started much lower and potentially titrated to this target dose.
- Depressive Episodes Associated With Bipolar 1 Disorder: 20 mg of Prozac a day is recommended as an initial dose in combination with 5 mg of Zyprexa, although a combination pill of 25 mg of Prozac and 6 mg of Zyprexa may be used.
- Treatment-Resistant Depression: Similar dosing of Prozac and Zyprexa to the recommendations for depressive episodes associated with bipolar 1 disorder are often used.
Children with major depressive disorder and obsessive-compulsive disorder are typically given an initial dose of 10 mg. Elderly people and people who have a hepatic impairment are also prescribed lower dosages.
While administering Prozac to pregnant women is avoided if possible, especially in their last trimester, your doctor might carefully weigh the pros and cons and decide to prescribe Prozac.
How to Take and Store
Prozac can be taken with or without food. It should be stored at room temperature and kept away from direct sunlight. Don’t store this medication in your bathroom because bathrooms tend to be moist which is not an ideal environment for storage.
Take Prozac at the time recommended by your doctor, which in most cases is in the morning. If you are taking a delayed-release capsule, swallow it whole, don’t crush, chew or cut it before taking.
Like with most SSRIs, it might take several weeks before you start seeing positive effects from Prozac. Don’t discontinue it even if you feel you aren’t getting better yet or if you feel you don’t need it anymore.
Prozamight cause some side effects, these effects typically go away with time. However, if you experience persistent, bothersome, or worsening side effects, you should tell your doctor about it.
Some common but mild side effects of using Prozac include:
- Low libido
- Loss of appetite
- Weight changes
- Stuffy nose
- Dry mouth
Some of these symptoms will pass shortly after you start using the medication. However, if you experience any new side effects or if any old side effects start to worsen, then you should report it to your medical doctor.
Some people might experience more severe side effects while using Prozac. In rare cases, Prozac could also cause a rare condition known as Serotonin syndrome, particularly if used in combination with other medications that impact serotonin.
This condition occurs when there’s excessive serotonin in your body, and can cause symptoms of fever, nausea, hallucinations, agitation, and coordination problems. If you suspect you are someone you know is showing signs of serotonin syndrome, contact your doctor immediately.
Less than 1 in 100 people experience severe side effects when using this medication.
Warnings and Interactions
If you are on any monoamine oxidase inhibitors (MAOI) like Marplan, you shouldn’t be taking Prozac. Prozac is typically not prescribed to people who have been taking am MAOI for at least 14 days. MAOIs are also typically not prescribed to people who have been on Prozac or who have stopped taking Prozac less than five weeks before their consultation.
People with major depressive disorder who are already prone to experiencing suicidal thoughts might sometimes experience the development of suicidal thoughts or a worsening of suicidal thoughts while taking Prozac.
It’s important to watch out for any sudden or unusual changes in their behavior, especially during the first couple of months of use. Teenagers and young adults who are aged between 18 and 24 are particularly at risk.
Tips for Coping With Nausea While on Antidepressants
Nausea and vomiting are two of the more common side effects of antidepressants, and it may take some time to get over these symptoms when first starting treatment.
In fact, nausea is often cited as the number one side effect of selective serotonin reuptake inhibitors (SSRIs) used to treat major depression and anxiety disorders. In some cases, nausea and vomiting can become so severe or persistent that a person has no other option but to stop treatment.
Verywell / Brianna Gilmartin
Nausea and vomiting are common side effects of many drugs. These symptoms are more often due to the effect a drug has on the central nervous system (CNS) rather than any toxic effect it has on the stomach or gastrointestinal tract (GI tract).
The situation is slightly different with SSRI antidepressants. This class of drug works by stimulating the effects of serotonin, a neurotransmitter associated with mood, cognition, and appetite.
When serotonin levels increase under the influence of SSRIs, they stimulate serotonin receptors in the GI tract as well as the brain. The combined stimulatory effect—on both the GI tract and CNS—can trigger such side effects as:
- Loss of appetite (anorexia)
Call your doctor if you experience persistent vomiting for more than 24 hours and have signs of moderate dehydration, or if vomiting and diarrhea are both present.
Antidepressants can also cause nausea and vomiting when treatment is stopped too suddenly. Known as antidepressant discontinuation syndrome (or simply antidepressant withdrawal), the condition can cause an array of symptoms if the body is suddenly deprived of the drug. Gastrointestinal symptoms are among the most common and potentially severe.
Antidepressant withdrawal symptoms can sometimes persist for several weeks and even lead to rebound depression (in which depressive symptoms return, sometimes worse than before).
In addition to nausea and vomiting, antidepressant withdrawal can cause the following:
- Panic attacks
- Profuse sweating
- Vivid dreams
People who have taken antidepressants for longer than six weeks are more likely to experience withdrawal unless the daily dose is gradually tapered.
Risk by Drug Type
Nausea and vomiting doesn’t only occur with SSRIs. The symptoms are also common with other classes of antidepressants, albeit less commonly or profoundly, including:
- Selective norepinephrine-dopamine reuptake inhibitors (SNDRIs) such as Wellbutrin (Buproprion)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
Nausea and vomiting are less common with a class of antidepressants known as monoamine oxidase inhibitors (MAOIs).
Minimizing Antidepressant Nausea
In most cases, nausea and vomiting will develop soon after treatment is started and gradually resolve within one to two weeks once the body adapts to the medication. However, according to some research, as many as 32% of people taking an SSRI will continue to experience GI symptoms for up to three months.
Fortunately, there are things you can do to minimize these symptoms:
- Take your medication with food, unless you are told otherwise.
- Take your antidepressant at bedtime to sleep through the worst of the symptoms.
- Eat smaller meals, more frequently.
- Suck on sugarless, hard candy whenever you are nauseous.
- Take an antacid like Pepcid (famotidine) or Tums.
- Sip ginger tea or slightly flattened ginger ale.
- Ask your doctor about a slow-release form of your antidepressant, or whether you need to temporarily lower your dosage.
- Talk to your doctor about anti-nausea medication, such as Zofran (ondansetron).
While proton pump inhibitors like Prilosec (omeprazole) may help, they can sometimes increase the concentration of certain antidepressants in your blood and may require a dose adjustment to avoid new or worsening side effects.
If your nausea or vomiting becomes intolerable, your doctor may have no other choice but to change treatment to another antidepressant with a lower nausea risk.
Drug Tapering Strategies
To reduce the risk of withdrawal symptoms when stopping an antidepressant, speak with your doctor about the appropriate tapering strategy. Going “cold turkey” is never advised and may end up triggering the very symptoms you were being treated for.
As a general rule, the longer you’ve been on antidepressants, the longer and slower the tapering period will be. Some people can be tapered off in a matter of weeks; others may take months.
Most doctors will reduce the daily dosage in three to four stages, maybe more if you’ve been on a drug for a long time. The following are some examples of tapering schedules by medication.
- Starting dose: 60 milligrams (mg)
- 1st dose reduction: 40mg
- 2nd dose reduction: 30mg
- 3rd dose reduction: 20mg
- 4th dose reduction: 10mg
- Starting dose: 40mg
- 1st dose reduction: 30mg
- 2nd dose reduction: 20mg
- 3rd dose reduction: 10mg
- Starting dose: 20mg
- 1st dose reduction: 15mg
- 2nd dose reduction: 10mg
- 3rd dose reduction: 5mg
- Starting dose: 60 mg
- 1st dose reduction: 40 mg
- 2nd dose reduction: 30 mg
- 3rd dose reduction: 20 mg
- 4th dose reduction: 10 mg
- Starting dose: 200mg
- 1st dose reduction: 150mg
- 2nd dose reduction: 100 mg
- 3rd dose reduction: 75mg
- 4th dose reduction: 50mg
Tapering should always be done under the supervision of a doctor. In some cases, tapering may require altering doses if an interim dose is not available. (For example, you may need to take 40mg one day and 20mg the next if a 30mg pill is not available.)
Unless otherwise directed, never cut an antidepressant in half as this may affect the speed in which it is absorbed and may trigger side effects. Call your doctor immediately if you experience any signs of withdrawal.
Escitalopram (Lexapro) | NAMI: National Alliance on Mental Illness
- Tablets: 5 mg, 10 mg, 20 mg
- Liquid: 1 mg/mL
- Tablets: 5 mg, 10 mg, 20 mg
- Liquid: 1 mg/ml
Generic name: escitalopram (es sye TAL oh pram)
All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.
What Is Escitalopram And What Does It Treat?
Escitalopram is an antidepressant medication that works in the brain. It is approved for the treatment of major depressive disorder (MDD) and generalized anxiety disorder (GAD).
Symptoms of depression include:
- Depressed mood – feeling sad, empty, or tearful
- Feeling worthless, guilty, hopeless, and helpless
- Loss of interest or pleasure in your usual activities
- Sleep and eat more or less than usual (for most people it is less)
- Low energy, trouble concentrating, or thoughts of death (suicidal thinking)
- Psychomotor agitation (‘nervous energy’)
- Psychomotor retardation (feeling like you are moving and thinking in slow motion)
- Suicidal thoughts or behaviors
Generalized anxiety disorder (GAD) occurs when a person experiences excessive anxiety or worry for at least six months. Other symptoms include:
- Fatigue (low energy, feeling tired all the time)
- Difficulty concentrating
- Muscle tension
- Sleep disturbance (difficulty falling asleep or waking up in the middle of the night)
Escitalopram may also be helpful when prescribed “off-label” for obsessive compulsive disorder (OCD), eating disorders such as binge eating disorder or bulimia nervosa, panic disorder, posttraumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD). “Off-label” means that it hasn’t been approved by the Food and Drug Administration for this condition. Your mental health provider should justify his or her thinking in recommending an “off-label” treatment. They should be clear about the limits of the research around that medication and if there are any other options.
What Is The Most Important Information I Should Know About Escitalopram?
Do not stop taking escitalopram, even when you feel better. With input from you, your health care provider will assess how long you will need to take the medicine.
Missing doses of escitalopram may increase your risk for relapse in your symptoms.
Stopping escitalopram abruptly may result in one or more of the following withdrawal symptoms: irritability, nausea, feeling dizzy, vomiting, nightmares, headache, and/or paresthesias (prickling, tingling sensation on the skin).
Depression is also a part of bipolar illness. People with bipolar disorder who take antidepressants may be at risk for “switching” from depression into mania. Symptoms of mania include “high” or irritable mood, very high self-esteem, decreased need for sleep, pressure to keep talking, racing thoughts, being easily distracted, frequently involved in activities with a large risk for bad consequences (for example, excessive buying sprees).
Medical attention should be sought if serotonin syndrome is suspected. Please refer to serious side effects for signs/symptoms.
Are There Specific Concerns About Escitalopram And Pregnancy?
If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with MDD who wish to become pregnant face important decisions. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers. For women who take antidepressant medications during weeks 13 through the end of their pregnancy (second and third trimesters), there is a risk that the baby can be born before it is fully developed (before 37 weeks).
For mothers who have taken SSRIs during their pregnancy, there appears to be less than a 1% chance of infants developing persistent pulmonary hypertension. This is a potentially fatal condition that is associated with use of the antidepressant in the second half of pregnancy. However, women who discontinued antidepressant therapy were five times more likely to have a depression relapse than those who continued their antidepressant. If you are pregnant, please discuss the risks and benefits of antidepressant use with your health care provider.
Caution is advised with breastfeeding since escitalopram does pass into breast milk.
What Should I Discuss With My Health Care Provider Before Taking Escitalopram?
- Symptoms of your condition that bother you the most
- If you have thoughts of suicide or harming yourself
- Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects
- If you experience side effects from your medications, discuss them with your provider. Some side effects may pass with time, but others may require changes in the medication.
- Any other psychiatric or medical problems you have, including a history of bipolar disorder
- All other medications you are currently taking (including over the counter products, herbal and nutritional supplements) and any medication allergies you have
- Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.
- If you are pregnant, plan to become pregnant, or are breastfeeding
- If you drink alcohol or use drugs
How Should I Take Escitalopram?
Escitalopram is usually taken one time per day with or without food.
Typically patients begin at a low dose of medicine and the dose is increased slowly over several weeks.
The dose usually ranges from 10 mg to 20 mg. Only your health care provider can determine the correct dose for you.
The liquid should be measured with a dosing spoon or oral syringe which you can get from your pharmacy.
Consider using a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take your medication. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.
What Happens If I Miss A Dose Of Escitalopram?
If you miss a dose of escitalopram, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your next dose or take more than what is prescribed.
What Should I Avoid While Taking Escitalopram?
Avoid drinking alcohol or using illegal drugs while you are taking antidepressant medications. They may decrease the benefits (e.g., worsen your condition) and increase adverse effects (e.g., sedation) of the medication.
What Happens If I Overdose With Escitalopram?
If an overdose occurs, call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.
A specific treatment to reverse the effects of escitalopram does not exist.
What are the possible side effects of Escitalopram?
Common side effects
Headache, nausea, diarrhea, dry mouth, increased sweating, feeling nervous, restless, fatigue, or having trouble sleeping (insomnia). These will often improve over the first week or two as you continue to take the medication.
Sexual side effects, such as problems with orgasm or ejaculatory delay often do not diminish over time.
Rare/serious side effects
Low sodium blood levels (symptoms of low sodium levels may include headache, weakness, difficulty concentrating and remembering), teeth grinding, angle closure glaucoma (symptoms of angle closure glaucoma may include eye pain, changes in vision, swelling or redness in or around eye), serotonin syndrome (symptoms may include shivering, diarrhea, confusion, severe muscle tightness, fever, seizures, and death), seizure
SSRI antidepressants including escitalopram may increase the risk of bleeding events. Combined use of aspirin, nonsteroidal anti-inflammatory drugs (e.g., ibuprofen, naproxen), warfarin, and other anti-coagulants may increase this risk. This may include symptoms such as gums that bleed more easily, nose bleed, or gastrointestinal bleeding. Some cases have been life threatening.
Are There Any Risks For Taking Escitalopram For Long Periods Of Time?
To date, there are no known problems associated with long term use of escitalopram. It is a safe and effective medication when used as directed.
What Other Medications May Interact With Escitalopram?
Escitalopram should not be taken with or within 2 weeks of taking monoamine oxidase inhibitors (MAOIs). These include phenelzine (Nardil®), tranylcypromine (Parnate®), isocarboxazid (Marplan®), rasagiline (Azilect®), and selegiline (Emsam®).
Although rare, there is an increased risk of serotonin syndrome when escitalopram is used with other medications that increase serotonin, such as other antidepressants, migraine medications called “triptans” (e.g., Imitrex®), some pain medications (e.g., tramadol (Ultram®), the antibiotic linezolid (Zyvox®), and amphetamines.
Escitalopram may increase the effects of other medications that can cause bleeding (e.g., ibuprofen (Advil®, Motrin®), warfarin (Coumadin®) and aspirin).
How Long Does It Take For Escitalopram To Work?
Sleep, energy, or appetite may show some improvement within the first 1-2 weeks. Improvement in these physical symptoms can be an important early signal that the medication is working. Depressed mood and lack of interest in activities may need up to 6-8 weeks to fully improve.
Summary of FDA Black Box Warnings
Suicidal thoughts or actions in children and adults
Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications. This risk may persist until significant remission occurs.
In short-term studies, antidepressants increased the risk of suicidality in children, adolescents, and young adults when compared to placebo. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24. Adults age 65 and older taking antidepressants have a decreased risk of suicidality. Patients, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness and insomnia. If these symptoms emerge, they should be reported to the patient’s prescriber or health care professional. All patients being treated with antidepressants for any indication should watch for and notify their health care provider for worsening symptoms, suicidality and unusual changes in behavior, especially during the first few months of treatment.
©2020 The College of Psychiatric and Neurologic Pharmacists (CPNP) and the National Alliance on Mental Illness (NAMI). CPNP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.
This information is being provided as a community outreach effort of the College of Psychiatric and Neurologic Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The College of Psychiatric and Neurologic Pharmacists disclaims any and all liability alleged as a result of the information provided herein.
Escitalopram: MedlinePlus Drug Information
A small number of children, teenagers, and young adults (up to 24 years of age) who took antidepressants (‘mood elevators’) such as escitalopram during clinical studies became suicidal (thinking about harming or killing oneself or planning or trying to do so). Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. However, experts are not sure about how great this risk is and how much it should be considered in deciding whether a child or teenager should take an antidepressant. Children younger than 12 years of age should not normally take escitalopram, but in some cases, a doctor may decide that escitalopram is the best medication to treat a child’s condition.
You should know that your mental health may change in unexpected ways when you take escitalopram or other antidepressants even if you are an adult over 24 years of age. You may become suicidal, especially at the beginning of your treatment and any time that your dose is increased or decreased. You, your family, or your caregiver should call your doctor right away if you experience any of the following symptoms: new or worsening depression; thinking about harming or killing yourself, or planning or trying to do so; extreme worry; agitation; panic attacks; difficulty falling asleep or staying asleep; aggressive behavior; irritability; acting without thinking; severe restlessness; and frenzied abnormal excitement. Be sure that your family or caregiver knows which symptoms may be serious so they can call the doctor if you are unable to seek treatment on your own.
Your healthcare provider will want to see you often while you are taking escitalopram, especially at the beginning of your treatment. Be sure to keep all appointments for office visits with your doctor.
The doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you begin treatment with escitalopram. Read the information carefully and ask your doctor or pharmacist if you have any questions. You also can obtain the Medication Guide from the FDA website: http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm.
No matter your age, before you take an antidepressant, you, your parent, or your caregiver should talk to your doctor about the risks and benefits of treating your condition with an antidepressant or with other treatments. You should also talk about the risks and benefits of not treating your condition. You should know that having depression or another mental illness greatly increases the risk that you will become suicidal. Tell your doctor if you or anyone in your family has or has ever had bipolar disorder (mood that changes from depressed to abnormally excited) or mania (frenzied, abnormally excited mood) or has thought about or attempted suicide. Talk to your doctor about your condition, symptoms, and personal and family medical history. You and your doctor will decide what type of treatment is right for you.
Lexapro Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing
Before taking escitalopram, tell your doctor or pharmacist if you are allergic to it; or to citalopram; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: personal or family history of bipolar/manic-depressive disorder, personal or family history of suicide attempts, liver disease, seizures, intestinal ulcers/bleeding (peptic ulcer disease) or bleeding problems, low sodium in the blood (hyponatremia), personal or family history of glaucoma (angle-closure type).
Escitalopram may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.
The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using escitalopram, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, recent heart attack, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).
Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using escitalopram safely.
This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).
The liquid form of this medication may contain sugar and/or aspartame. Caution is advised if you have diabetes, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this medication safely.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, such as QT prolongation (see above), loss of coordination, or bleeding. They may also be more likely to lose too much salt (hyponatremia), especially if they are also taking “water pills” (diuretics) with this medication. Loss of coordination can increase the risk of falling.
Children may be more sensitive to the side effects of this drug, especially loss of appetite and weight loss. Monitor weight and height in children who are taking this drug.
During pregnancy, this medication should be used only when clearly needed. It may harm an unborn baby. Also, babies born to mothers who have used this drug during the last 3 months of pregnancy may rarely develop withdrawal symptoms such as feeding/breathing difficulties, seizures, muscle stiffness, or constant crying. If you notice any of these symptoms in your newborn, tell the doctor promptly.
Since untreated mental/mood problems (such as depression, anxiety, obsessive-compulsive disorder, panic disorder) can be a serious condition, do not stop using this medication unless directed by your doctor. If you are planning pregnancy, become pregnant, or think you may be pregnant, immediately discuss with your doctor the benefits and risks of using this medication during pregnancy.
This medication passes into breast milk and may have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
Escitalopram| Health Navigator NZ
Escitalopram is used to treat depression, obsessive compulsive disorder and anxiety (social anxiety and generalised anxiety). Find out how to take it safely and possible side effects. Escitalopram is also called Loxalate or Lexapro.
|Type of medicine||Also called|
What is escitalopram?
Escitalopram is used to treat depression, panic disorders, anxiety (social anxiety and generalised anxiety) and obsessive compulsive disorder. It is one of a group of medicines known as selective serotonin reuptake inhibitors (SSRIs). It is believed that SSRIs work by increasing the activity of certain chemicals in our brains called neurotransmitters, which pass signals from one brain cell to another. Although we don’t know for certain, the neurotransmitters that are most likely to be involved in depression are thought to be serotonin and noradrenaline. Selective serotonin reuptake inhibitors (SSRIs) are the most frequently prescribed antidepressants. SSRIs are called selective because they only affect serotonin. In New Zealand, escitalopram is available as tablets. Read more about antidepressants and SSRIs.
- The usual dose of escitalopram is 10 milligrams once a day.
- Depending on your response, and if you need to, your doctor may increase your dose to 20 milligrams once a day.
- Always take your escitalopram exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much escitalopram to take, how often to take it and any special instructions.
How to take escitalopram
- Timing: Take escitalopram once a day, at the same time each day, either in the morning OR in the evening. You can take it at a time to suits you, but try to take your dose at the same time of day, each day. You can take escitalopram with or without food but if you think it is upsetting your stomach, try taking it with food.
- Missed dose: If you forget to take your tablet, take it as soon as you remember. But, if it is nearly time for your next tablet, just take the next tablet at the right time. Do not take double the amount of tablets.
- Keep taking escitalopram every day. It may take 4 to 6 weeks before you notice the full benefits of escitalopram. If you think escitalopram is not working for you, do not stop taking it suddenly; speak to your doctor or nurse before stopping. It is usually best to stop taking escitalopram very slowly to avoid side effects.
Read more about what to expect when starting SSRIs – see SSRIs and frequently asked questions (FAQs) about SSRIs.
Precautions – before starting escitalopram
- Do you have any heart problems such as irregular heartbeat?
- Have you had problems with mania or psychosis?
- Do you have problems with your kidneys or liver?
- Do you have epilepsy?
- Do you have diabetes?
- Are you pregnant or breastfeeding?
- Do you have a bleeding disorder or stomach ulcer?
- Are you taking any other medicines, including medicines you can buy without a prescription, such as herbal and complementary medicines or pain relief medicines?
If any of these apply, it’s important that you tell your doctor or pharmacist before you start escitalopram. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.
Precautions – while taking escitalopram
- Alcohol: avoid alcohol while you are taking escitalopram, especially when you first start treatment. Drinking alcohol while taking SSRIs can cause drowsiness and affect concentration, putting you at risk of falls and other accidents. It can also cause agitation, aggression and forgetfulness. If you do drink alcohol, drink only small amounts and see how you feel. Do not stop taking your medication.
- Diabetes: if you have diabetes, you may need to check your blood glucose more often because escitalopram can affect the levels of glucose in your blood.
Possible side effects
Like all medicines, escitalopram can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.
The use of antidepressants has been linked with an increase in suicidal thoughts and behaviour. Children, teenagers, young adults and people with a history of suicidal behaviour are particularly at risk. This is most likely during the first few weeks of starting an antidepressant or if the dose is changed. It is important to look for signs of suicidal behaviour such as agitation or aggression and ask about suicidal thoughts, self-harm, worsening of low mood, If you notice any of these signs, contact your doctor immediately.
It is okay and important to ask about suicidal thoughts and this will not increase risk. Note: escitalopram is not recommended for people under 18 years of age.
If you need urgent help or are concerned, phone:
- Lifeline 0800 543 354 (available 24/7), or
- Healthline 0800 611 116, who can give you the phone number for your local mental health crisis line.
Risk of bleeding
SSRIs can increase your risk of bleeding especially if taken with NSAIDs (non-steroidal anti-inflammatory drugs) such as diclofenac and ibuprofen. Check with your doctor or pharmacist before you take pain relief.
Sexual side effects
SSRIs in both men and women can cause reduced sexual drive, lack of libido and problems keeping an erection and reduce the intensity of orgasm. It’s important to talk to your healthcare provider if you get these effects, as they can be difficult to deal with and may not go away. Your healthcare provider may be able to suggest treatment or may reduce the dose of the SSRI or change to a different one. Read more about medicines and sexual problems.
Other side effects
|Side effects||What should I do?|
Escitalopram interacts with a number of medications (including pain relief medicines) and herbal supplements (such as St.John’s Wort) so check with your doctor or pharmacist before starting escitalopram or before starting any new medicines.
The following links provide more information on escitalopram:
Escitalopram (Māori) New Zealand Formulary Patient Information
Escitalopram (Air Flow); Lexapro; Loxalate Medsafe Consumer Information Sheets
- Escitalopram New Zealand Formulary
- Selective serotonin re-uptake inhibitors New Zealand Formulary
- The role of medicines in the management of depression in primary care BPAC, 2017
When a series of difficult family and financial issues simultaneously came to a head, 43-year-old Suzanne* began to feel herself spiraling down into a dark and seemingly inescapable place in her mind that she suspected was true depression. A visit to a psychiatrist confirmed her suspicions and together she and the doctor agreed that antidepressant medication was necessary at that time. The psychiatrist prescribed Lexapro, and within just a couple of weeks of taking the first pill, Suzanne began to feel more hopeful and more like her old self again. Throughout the 18 months she took Lexapro, her mental outlook improved and remained healthy so she was able to work with a psychotherapist and learn to cope with what had felt like overwhelming personal circumstances. Her life improved.
Not so for 16-year old Coralie*, who struggled with severe anxiety and panic attacks in high school and was also prescribed Lexapro. Within two weeks of starting medication, instead of feeling better, her mood became darker and darker. Soon Coralie began to have suicidal thoughts. She never acted on those thoughts, but after they become powerful enough to land her in the emergency room, she stopped taking Lexapro, and her parents sought new treatment that involved more intensive psychotherapy.
“Most people feel better with antidepressants but, for some—especially those under the age of 25 and those with bipolar depression—these drugs can make mental disturbances feel even worse,” says Psycom Editorial Board Advisor Chris Aiken, MD. Dr. Aiken is also the director of the Mood Treatment Centers in western North Carolina and editor-in-chief of The Carlat Psychiatry Report. “Keep in close contact with your doctor if you’re not feeling better or you actually feel worse, because it can be difficult for you to tell if such a response is the sign of a serious reaction or simply a side effect that is harmless and will go away with time,” he says.
How Does Lexapro Work?
Neither depression nor the activity of antidepressant medications, are fully understood. Depression has long been associated with lower-than-normal levels of a neurotransmitter, or chemical messenger in the brain, known as serotonin. Normally, serotonin helps transport messages from one neuron (brain cell) to another, then moves on and is recycled, so that messaging can be continued. Like other SSRI antidepressants, Lexapro slows down this process, which increases the amount of serotonin available to brain cells at any given time and correcting what is thought to be a chemical imbalance. Newer research suggests that this increase of serotonin, over time, alters other brain systems as well and that those alterations are actually responsible for improvements in mood.
“Lexapro raises the levels of neuroprotective compounds in the brain,” Dr. Aiken adds. “These compounds help cells located in the mood center of the brain to grow and strengthen, resulting in improved connections and communication between brain cells.”
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Depression is also viewed as an inflammatory condition, and some research suggests that SSRIs work because they have anti-inflammatory properties. However, other research suggests that some SSRIs are not effective in people whose blood contains markers or indicators of inflammation. 1,2 These types of conflicting results help medical experts understand why and how some types of antidepressant medications may work for some people but not for others.
For what specific conditions is Lexapro prescribed?
Lexapro is classified as an antidepressant commonly used to treat major depressive disorders and generalized anxiety disorder. At their discretion, physicians may prescribe Lexapro for other conditions, including panic disorder, social phobia, obsessive-compulsive disorder, bulimia, and post-traumatic stress disorder.
What is a typical dose of Lexapro?
The standard initial dose of Lexapro is usually 10 mg, once daily, in the morning or evening, with or without food. If Lexapro makes you feel drowsy, it is a good idea to take it in the evening. In some cases, doctors will have a patient graduate to a higher dose. It can take three to six weeks to start feeling the effects of Lexapro, although some people respond sooner.
If you forget to take Lexapro, take your missed dose as soon as you remember. But if it’s almost time for your next dose, skip the missed dose and get back on schedule. Don’t take a double dose and don’t take more than your prescribed amount of Lexapro in any 24-hour period of time.
Can anyone take Lexapro?
Lexapro may be prescribed for adults and some adolescents, however, SSRIs are not recommended for use in all young people, due to an increased risk of suicidal thoughts and behavior in some children and young adults. The risk is especially high in those who have previously experienced suicidal thought or behaviors. Young people, their families, and caregivers should be aware of this risk and discuss any concerns with the prescribing physician, who can best determine if the benefits of taking Lexapro outweigh the risks.3
Before starting Lexapro treatment, be sure your doctor knows about any other physical or mental health conditions you have, as well as any prescription or over-the-counter medications, supplements, or herbal products you use to treat any medical or psychological condition, including other antidepressant treatments.
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“Even a ‘natural’ product like St. John’s Wort can cause serious problems when taken with an SSRI,” warns Dr. Aiken. “The combination can cause a rare but serious condition known as Serotonin Syndrome, with side effects like muscle jerks, racing heart, confusion, mood swings, gastrointestinal distress and other symptoms that result from too much serotonin in the brain.”
It is also important to tell your doctor if you have experienced allergic reactions to drugs similar to Lexapro or to any other type of drug or substance in the past. This information will help your doctor determine if it is safe for you to take Lexapro. Be aware that dangerous and potentially life-threatening reactions can occur with the use of Lexapro, especially when combined with other drugs.
Genetic testing may help determine whether or not Lexapro is the right medication for you, though the results are not always 100% accurate and the tests are not always covered by health insurance plans because evidence-based recommendations and testing standards have yet to be established. 4 Medical testing for markers of inflammation, also not yet a common practice in psychiatry, might also help narrow down your best choices for antidepressant medication. Speak to your health care providers if you are interested in pursuing these types of tests.
Are there side effects associated with taking Lexapro?
Anyone taking Lexapro or another SSRI should be closely supervised by an MD and monitored for side effects. The doctor should be notified if mood does not improve after a specified time or appears to worsen at any time. Other side effects that should be reported immediately to the prescribing doctor include:
- Feelings of panic
- Any changes in mood or behavior
- Increased heartbeat
- Muscle stiffness
- Nausea, diarrhea or vomiting
- Changes in blood pressure
- Loss of physical coordination
“SSRIs can also have blood-thinning effects,” Dr. Aiken points out, “so you may notice an increase in menstrual flow or other types of bleeding, and you may have to stop taking them if you are having surgery.”
Is it OK to suddenly stop taking Lexapro?
Always check first with your prescribing physician before you stop taking Lexapro, or change your dose. It is important to gradually taper off medications like Lexapro, and to watch for withdrawal symptoms while decreasing your dose. These symptoms—which may not be dangerous but can be very unpleasant—include dizziness, anxiety, insomnia, emotional instability, and sensations of electrical shock (“brain zaps”). If withdrawal symptoms are severe, your doctor may need to increase your reduced dose slightly and then prescribe a more gradual reduction.
Medically reviewed by Chris Aiken, MD
*Names changed to protect the privacy of the real patients who shared their stories with Psycom
- Wang L, Wang R, Liu L, et al. Effects of SSRIs on peripheral inflammatory markers in patients with major depressive disorder: A systematic review and meta-analysis. Brain, Behavior, and Immunity. Published online February 19, 2019. Available at: www.sciencedirect.com/science/article/pii/S0889159118304641 [abstract] Accessed April 9, 2019.
- Lindquist D, Dhabhar FS, James J, et al. Oxidative stress, inflammation and treatment response in major depression. Psychoneuroendocrinology. February 2017; 76:197-205 Available at: www.sciencedirect.com/science/article/pii/S0306453016306862. [abstract] Accessed April 9, 2019.
- Cousins L, Goodyer IM. Antidepressants and the adolescent brain. Journal of Psychopharmacology. March 5, 2015; 29(5) Available at: https://journals.sagepub.com/doi/10.1177/0269881115573542. [abstract] Accessed April 9, 2019.
- Bousman C, Abdullah M, Muller DJ. Towards the integration of pharmacogenetics in psychiatry. Current Opinion in Psychiatry. January 2019; 32(1):7-15. Available at: https://journals.lww.com/co-psychiatry/Abstract/2019/01000/Towards_the_integration_of_pharmacogenetics_in.3.aspx[abstract] Accessed April 9, 2019.
Last Updated: Jan 8, 2021
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This document, provided by Lexicomp ® , contains all the information you need to know about the drug, including the indications, route of administration, side effects and when you should contact your healthcare provider.
Trade names: USA
Trade names: Canada
ACH-Escitalopram; ACT Escitalopram ODT; ACT Escitalopram [DSC]; AG-Escitalopram; APO-Escitalopram; Auro-Escitalopram; BIO-Escitalopram; Cipralex; Cipralex Meltz [DSC]; JAMP-Escitalopram; M-Escitalopram; Mar-Escitalopram; MINT-Escitalopram; MYLAN-Escitalopram; NAT-Escitalopram; NRA-Escitalopram; PMS-Escitalopram; Priva-Escitalopram; RAN-Escitalopram; RIVA-Escitalopram; SANDOZ Escitalopram; TEVA-Escitalopram
For all patients taking this drug:
- Drugs like this have increased the likelihood of suicidal thoughts or actions in children and young people.This risk may be higher in people who have attempted suicide or have had suicidal thoughts in the past. All people taking this drug must be closely monitored. Call your doctor right away if you have signs such as depressed mood (depression), nervousness, anxiety, grumpiness, or anxiety attacks, or if other mood or behavior changes occur or worsen. Call your doctor right away if you have suicidal thoughts or attempted suicides.
- This drug is not approved for use in children of all ages. Check with your doctor to make sure this drug is right for your child.
What is this drug used for?
- The drug is used to treat depression.
- Used to treat anxiety.
- This medicinal product may also be used for other indications. Consult your doctor.
What should I tell my doctor BEFORE taking this drug?
- If you are allergic to this drug, any of its ingredients, other drugs, foods or substances. Tell your doctor about your allergy and how it manifested itself.
- If you are taking any of the following drugs: linezolid or methylene blue.
- If you are taking any of the following drugs: Citalopram or pimozide.
- If you have taken a drug for depression or Parkinson’s disease in the past 14 days.These include isocarboxazid, phenelzine, tranylcypromine, selegiline, or rasagiline. An episode of very high blood pressure may occur.
This list of drugs and diseases that may be adversely associated with this drug is not exhaustive.
Tell your doctor and pharmacist about all the medicines you take (both prescription and over-the-counter, natural products and vitamins) and your health problems.You need to make sure that this drug is safe for your medical conditions and in combination with other drugs you are already taking. Do not start or stop taking any drug or change the dosage without your doctor’s approval.
What do I need to know or do while taking this drug?
- Tell all healthcare providers that you are taking this drug.These are doctors, nurses, pharmacists and dentists.
- Avoid driving or other activities that require increased attention until you see how this drug affects you.
- Do not stop taking this drug abruptly without talking to your doctor. This can increase the risk of side effects. If necessary, this drug should be stopped gradually as directed by your doctor.
- Avoid drinking alcohol while taking this drug.
- Consult your doctor before using marijuana, other forms of cannabis, prescription or over-the-counter drugs that may slow you down.
- If you have depression after starting this drug, your sleep and appetite may improve quickly. Other symptoms of depressed mood may take up to 4 weeks to improve.
- This drug may increase the risk of bleeding. Sometimes bleeding can be life-threatening.Consult your doctor.
- This drug may lower sodium levels. Very low sodium levels can be life-threatening, leading to seizures, fainting, difficulty breathing, or death.
- If you are 65 years of age or older, use this drug with caution. You may have more side effects.
- In some cases, the drug may affect the growth rate in children and adolescents. They may need to check their growth rate regularly.Consult your doctor.
- Tell your doctor if you are pregnant, planning to become pregnant, or breastfeeding. The benefits and risks for you and your child will need to be discussed.
- Taking this drug during the third trimester of pregnancy may cause some health problems in the newborn. Consult your doctor.
What side effects should I report to my doctor immediately?
WARNING. In rare cases, some people with this drug can cause serious and sometimes deadly side effects. Call your doctor or get medical help right away if you have any of the following signs or symptoms, which may be associated with serious side effects:
- Signs of an allergic reaction such as rash, hives, itching, reddened and swollen skin with blistering or scaling, possibly associated with fever, wheezing or wheezing, tightness in the chest or throat, difficulty breathing, swallowing or speaking, unusual hoarseness, swelling in the mouth, face, lips, tongue, or throat.
- Signs of low sodium levels such as headache, trouble concentrating, memory impairment, confused thinking, weakness, seizures, and balance problems.
- Signs of bleeding such as vomiting or coughing up blood; vomiting of the type of coffee grounds; blood in the urine; black, red, or tarry stools; bleeding from the gums; non-cyclic vaginal bleeding; bruising that occurs or increases for no reason; bleeding that you cannot stop.
- Fever or chills.
- Sexual problems such as decreased sex drive or ejaculation problems.
- Penile erection that lasts more than 4 hours.
- The risk of eye problems may be increased in some patients with this drug. Your doctor may order you to see an ophthalmologist to see if you are at increased risk of developing these eye problems.Call your doctor right away if you have eye pain, change in vision, swelling, or redness around the eye.
- A serious and sometimes fatal complication called serotonin syndrome may occur. This risk may increase with the concomitant use of certain other drugs. Call your doctor right away if you develop agitation, imbalance, confusion, hallucinations, fever, tachycardia or irregular heartbeat, flushing, muscle twitching or stiffness, seizures, tremors or tremors, excessive sweating, severe diarrhea, nausea or vomiting , very severe headache.
What are some other side effects of this drug?
Any medicine can have side effects. However, many people have little or no side effects. Call your doctor or get medical help if these or any other side effects bother you or do not go away:
- Feeling dizzy, sleepy, tired, or weak.
- Diarrhea or constipation.
- Dry mouth.
- Sleep disorders.
- Excessive sweating.
- Flu-like symptoms.
- Runny nose.
This list of potential side effects is not exhaustive. If you have any questions about side effects, please contact your doctor. Talk to your doctor about side effects.
You can report side effects to the National Health Office.
You can report side effects to the FDA at 1-800-332-1088. You can also report side effects at https://www.fda.gov/medwatch.
What is the best way to take this drug?
Use this drug as directed by your healthcare practitioner. Read all the information provided to you. Follow all instructions strictly.
All forms of issue:
- Take this drug with or without food.
- Continue taking this drug as directed by your doctor or other healthcare professional, even if you feel well.
- Doses of liquid preparation should be measured with caution. Use the dispenser that comes with the medicine. If a dispenser is not included in the package, ask your pharmacist for a dosing product for this drug.
What should I do if a dose of a drug is missed?
- Take the missed dose as soon as you can.
- If it is time for your next dose, do not take the missed dose and then return to your normal dose.
- Do not take 2 doses at the same time or an additional dose.
How do I store and / or discard this drug?
- Store at room temperature in a dry place. Do not store in the bathroom.
- Store all medicines in a safe place. Keep all medicines out of the reach of children and pets.
- Dispose of unused or expired drugs. Do not empty into toilet or drain unless directed to do so. If you have any questions about the disposal of your medicinal products, consult your pharmacist. Your area may have drug recycling programs.
General information on medicinal products
- If your health does not improve or even worsens, see your doctor.
- You should not give your medicine to anyone and take other people’s medicines.
- Some medicines may have different patient information sheets. If you have questions about this drug, talk with your doctor, nurse, pharmacist, or other healthcare professional.
- A separate patient instruction sheet is attached to the product. Please read this information carefully. Reread it every time you replenish your supply.If you have questions about this drug, talk with your doctor, pharmacist, or other healthcare professional.
- If you think an overdose has occurred, call a Poison Control Center immediately or seek medical attention. Be prepared to tell or show which drug you took, how much and when it happened.
Use of information by the consumer and limitation of liability
This information should not be used to make decisions about taking this or any other drug.Only the attending physician has the necessary knowledge and experience to make decisions about which drugs are appropriate for a particular patient. This information does not guarantee that the drug is safe, effective, or approved for the treatment of any disease or specific patient. Here are only brief general information about this drug. It does NOT contain all available information on the possible use of the drug with instructions for use, warnings, precautions, information about interactions, side effects and risks that may be associated with this drug.This information should not be construed as a treatment guide and does not replace information provided to you by your healthcare professional. For complete information on the possible risks and benefits of taking this drug, consult your doctor. Use of this information is governed by the Lexicomp End User License Agreement available at https://www.wolterskluwer.com/en/solutions/lexicomp/about/eula.
© UpToDate, Inc.and its affiliates and / or licensors, 2021. All rights reserved.
90,000 Antidepressant therapy withdrawal syndrome: diagnosis, prevention and treatment
Withdrawal symptoms may occur after discontinuation of any class of antidepressant medication. The largest number of publications is devoted to selective serotonin reuptake inhibitors (SSRIs), apparently due to the fact that drugs of this class are most often prescribed for the treatment of depressive disorders.Usually these symptoms are mild and go away on their own after a while. However, some patients may require resumption of pharmacotherapy. This review briefly reviews the main clinical aspects of antidepressant discontinuation syndrome.
This condition is also called antidepressant withdrawal syndrome, although this is not entirely correct. The onset of symptoms after stopping therapy does not mean that the drug is addictive.Antidepressants are non-addictive and non-addictive. This is an important positive point, which must be communicated to patients, as most people will stop taking the prescribed treatment as soon as possible in the face of the fear of becoming dependent on the drug.
Why is it important to recognize antidepressant withdrawal syndrome?
There are three reasons: patient discomfort, diagnostic problem and possible compliance problems.While withdrawal symptoms are rarely life threatening, they are always associated with discomfort and some degree of psychosocial maladjustment. Hence the second problem: having experienced a withdrawal syndrome, the patient has difficulty agreeing to any psychopharmacotherapy in the future. Finally, symptoms resulting from the cessation of antidepressant action can be mistaken for an exacerbation of a depressive disorder, another mental disorder, or medical illness.
For example, consider two typical scenarios.After making sure that remission of major depressive disorder has been achieved, the doctor is in a hurry to please the patient that the antidepressant can be stopped, but forgets to advise how to do it correctly. The patient takes everything literally and forgets about the medicine the next day. After a week, he develops withdrawal symptoms, and he addresses his complaints a) to the same psychiatrist, who forgets to ask how the antidepressant was withdrawn and perceives the symptoms as a relapse of depression; b) to another specialist, for example, a neurologist, whom he prefers not to inform about treatment with a psychiatrist.And the neurologist interprets these nonspecific symptoms according to his competence. As a result, unnecessary examinations and possibly even treatment.
In addition, symptoms may be confused with side effects of a newly prescribed drug after antidepressant withdrawal, especially when switching between antidepressants with different mechanisms of action, such as from paroxetine (SSRI) to bupropion (a dopamine and norepinephrine reuptake inhibitor). This can lead to the erroneous conclusion that the patient does not tolerate the new drug well.Discontinuation symptoms can also be perceived as therapy failure, especially irritability and anxiety.
The symptoms of discontinuation of antidepressant therapy can be divided into six categories: sensory symptoms, imbalance, general somatic, affective, gastrointestinal symptoms, and sleep disorders (Fig.).
Initially, information about the listed manifestations was accumulated from reports of clinical cases. This problem was then studied in prospective double-blind clinical trials in which patients were specifically randomized to discontinue antidepressant therapy.
In the English-language literature, a mnemonic technique is used to memorize the spectrum of antidepressant withdrawal syndrome: the main symptoms are encoded in the word FINISH.
F – from “flu-like” – flu-like symptoms;
I – insomnia;
N – from “nausea” – nausea;
I – from “imbalance” – imbalance;
S – sensory symptoms;
H – from “hyperarousal” – increased excitability, which reflects affective disorders.
It should be noted that the symptoms shown in the figure are mainly associated with discontinuation of SSRI drugs and serotonin and norepinephrine reuptake inhibitors.The spectrum of symptoms during the withdrawal of monoamine oxidase (MAO) inhibitors and tricyclic antidepressants has its own specifics. So, in the case of discontinuation of tricyclic antidepressants, sensory symptoms and imbalance are usually not observed. With the withdrawal of MAO inhibitors, symptoms may be more pronounced than after the withdrawal of SSRIs. Patients may experience worsening depressive and anxiety symptoms, acute impairment of consciousness up to catatonia.
When do withdrawal symptoms appear and how long do they last?
They usually appear within the first week after stopping the antidepressant; according to research, on average on the second day.Spontaneous resolution occurs at different times – from 1 day to 3 weeks, on average, patients continue to experience symptoms for 10 days.
What determines the appearance of the withdrawal syndrome?
The syndrome is observed when antidepressants of all classes are discontinued. The largest number of messages was recorded for paroxetine. The half-life of a drug from blood plasma is the indicator that most correlates with the risk of withdrawal syndrome.In other words, the shorter the residual effect of the drug after the last dose, the higher the likelihood of symptoms.
For example, fluoxetine has a half-life of 7 days, so this SSRI has the lowest risk of withdrawal. Paroxetine has an average elimination half-life of 24 hours, hence the high risk of withdrawal syndrome, especially with abrupt cessation of the therapeutic dose.
Can antidepressant therapy withdrawal syndrome be distinguished from depression relapse?
Common symptoms include dysphoria, decreased appetite, sleep disturbances and fatigue.But there are also distinguishing features – symptoms that are rarely seen in depression, such as sensory phenomena (paresthesias), as well as dizziness, headache and nausea. In addition, in the case of withdrawal, a rapid (within 1 day) improvement can be observed when the drug is resumed, while recurrent depression does not respond so quickly to therapy.
Who is at risk of developing antidepressant withdrawal syndrome?
As a rule, these are patients who begin to feel better after several weeks of taking an antidepressant and are not well informed about the need for long-term maintenance therapy.Women who become aware of their pregnancy during treatment may also abruptly stop taking the antidepressant for safety reasons.
How to stop antidepressants to minimize the risk of withdrawal?
Patients should explain in an accessible form the features of the prescribed antidepressant action, the rules for increasing and gradually decreasing the dose, and warn of a possible deterioration in well-being in case of abrupt cessation of therapy. But at the same time, the words “withdrawal syndrome”, “addiction”, “dependence” should be avoided, since they can be perceived negatively and cause early discontinuation of therapy.Sooner or later, that happy moment comes when it becomes clear that antidepressants can be abandoned. However, the withdrawal process, as a rule, takes several weeks, but in some cases even longer, especially if the patient’s well-being worsens in the first steps of dose reduction. When fluoxetine is prescribed, it is possible to discontinue the drug without a gradual dose reduction, although this has not been specifically studied in studies.
If possible, you should also discuss with the patient’s relatives how to create the most favorable conditions at the time of antidepressant withdrawal.Patients with major depressive disorder, as a rule, do not work and are at home, therefore they are not exposed to external psycho-emotional stress. It is optimal if the patient’s close environment tries to create a positive atmosphere and tries to involve the family member in any activity in order to distract from the perception of possible withdrawal symptoms.
How can we help patients who complain of poor health after stopping antidepressant medication?
If this does happen, it should be explained to the patient that the symptoms are not life threatening and usually go away within a few days.If the patient continues to experience symptoms and they reduce quality of life, it is common practice to resume the therapeutic dose of the antidepressant. In the future, you can try again to cancel the drug through a very gradual dose reduction. If this does not help, then it is possible to transfer the patient to fluoxetine, an SSRI with the lowest risk of withdrawal, and then cancel it.
1. Haddad P.M., Anderson I.M. (2007). Recognizing and managing antidepressant discontinuation symptoms.Advances in Psychiatric treatment, 13 (6): 447-457.
2. Warner C. H., Bobo W., Warner C., Reid S., Rachal J. (2006). Antidepressant discontinuation syndrome. American Family Physician, 74 (3): 449-456.
3. Renoir T. (2013). Selective serotonin reuptake inhibitor antidepressant treatment discontinuation syndrome: a review of the clinical evidence and the possible mechanisms involved. Frontiers in Pharmacology, 4.
Prepared by Dmitry Molchanov
STATTIES FOR THE TOPIC Psychiatry
Principles for the treatment of depression and novelty of modern antidepressants
Tsiogorich near the birch tree is a scientifically practical online conference with international participation “The current paradigm of rational therapy for neurological illnesses.”A visit to the assignment to discuss the specific aspects of diagnostics, treatment and rehabilitation in the most common mental disorders and neurological disabilities, as well as injecting the COVID-19 pandemic in the mental health of the population. From additional advice on the topic “Effectiveness of antidepressant therapy: problems and solutions” was presented by Dr. med. D., professor, patron of the director of scientific robotics of the Institute of Neurology, Psychiatry and Narcology of the National Academy of Medical Sciences of Ukraine Natalia Oleksandrivna Maruta ….
Psychotherapy for Depression: Notes in the Margins
Considering the entire psychotherapeutic process from beginning to end, it may be useful to ask the Reader, who has, albeit a little, experience in this area, a simple riddle question: where should one begin and how should one begin and end a psychotherapy for a particular patient? There can be many answers, of course; you can compare the Reader’s opinion with the correct one (in the opinion of the author) at the end of the article….
Lexapro (escitalopram) | Selective serotonin reuptake inhibitors
Lexapro (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It is commonly used to treat anxiety in adults, depression in adults and adolescents 12 years of age and older, tension, and excessive anxiety.It works primarily by increasing the amount of a neurotransmitter. serotonin. It does this by preventing reuptake of the presynaptic cell membrane. This SSRI medication is only available with a prescription from a doctor or psychiatrist.
Frequently asked dosage questions
- How to get the best results from this drug?
Many conditions for which Lexapro is prescribed also show positive results from psychotherapy.Medications can dull debilitating symptoms of anxiety and depression, but medications do not teach a person healthy ways to deal with symptoms such as emotions, or behavior arises or is triggered by a mental health condition. If you have been prescribed an SSRI antidepressant, consider finding a qualified therapist or counselor to learn more about your experience and help you find healthy ways to improve your quality of life. In addition, many people with anxiety and depression report positive results from exercises such as yoga, meditation, and breathing activities.Many therapists offer specialized training in these mental health treatments that can reduce stress, anxiety, and symptoms of depression.
- How should I take this medicine?
Lexapro can be given as a tablet or liquid. It is usually taken once a day, with or without food. For best results, take this medication at the same time every day. Your doctor may gradually increase the number of medications you are taking to find the dosage that’s best for you.It may take about 30 days to fully feel the effects of this medication. Continue to take this medication as directed by your doctor, even if you feel well. Don’t let others take your medication, even if they have similar symptoms. This drug is not approved for use in children under 12 years of age.
- What should I do if I forget to take my medicine?
Take the missed medication as soon as you remember it. If you are getting close to taking your next dose, do not take the missed dose.Just stick to your usual medication schedule. Taking too many of this SSRI too quickly can contribute to overdose.
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Advanced Search What should I do if I overdose with this drug?
Seek emergency medical attention or call a Poison Control Center as soon as possible. Overdose signs include sweating, drowsiness, heart palpitations, seizures, nausea, or loss of consciousness.
- What is the best way to store this medicine?
Do not store this medicine in the bathroom or kitchen. Store this medication tightly closed in its original container at room temperature. Avoid exposing the container to excessive heat or moisture. Keep this medication out of the reach of children.
- Are there any drug interactions I should be aware of?
Lexapro may interact negatively with certain medications and supplements, including: monoamine oxidase inhibitors (MAOIs), aspirin, anti-inflammatory drugs such as ibuprofen (Motrin) and naproxen (Aleve), migraine medications, anticoagulants, antihistamines, antidepressants, anxiolytics , medications for sleep problems, typical and atypical antipsychotics, blood pressure medications, vitamins, minerals, herbal products (especially the herb St. John’s wort), foods containing tryptophan, and more.Do not take this medication with other SSRIs, especially Celexa.
Recommendations before use
Antidepressants, including Lexapro, can cause intense suicidal feelings or suicidal behavior in children, adolescents and young adults under 24 years of age. Ask your doctor if using this medication outweighs the risks.
This medicine may cause angle-closure glaucoma, an eye condition that can lead to blindness.It is recommended that you have a thorough eye examination before taking this medication.
It is important to discuss your complete health history with your doctor before taking Lexapro. Tell your doctor if you have had a heart attack, liver, kidney, or heart disease, thyroid problems, seizures, or diabetes. Report possible reactions to other medications. If you become pregnant while taking this medication, ask your doctor about alternative treatments.
Do not buy this medicine outside the United States or on the Internet. Medicines purchased from these sources may not be available from a licensed pharmacy. Haloperidol, a potent antipsychotic drug with potentially dangerous side effects, has been found in some samples of Lexapro obtained over the Internet.
Warnings during use
If you start taking this medicine, there are some important things to keep in mind:
- This medicine may cause withdrawal effects, lung conditions, heart defects and other serious defects in newborns if taken during pregnancy.According to one study, women who take SSRIs during pregnancy may be more likely to have premature babies than women who do not take SSRIs and are not depressed. Escitalopram, the main ingredient in Lexapro, can pass into breast milk and harm a nursing baby. If you become pregnant, you should not stop taking this medication unless recommended by your doctor.
- This drug may cause drowsiness. Do not drive, drive, or use heavy equipment until you know how this medication is working for you.
- Avoid drinking alcohol in which this medication is taken as it may increase potential side effects.
- If you are scheduled for any type of surgery, tell your surgeon or anesthetist that you are being treated with Lexapro. This warning applies to oral surgery.
Possible side effects
Contact your doctor if you experience any of the following side effects. Serious side effects that can occur while taking Lexapro include:
- Flu symptoms, including fever
- Stiff muscles
- Visual or auditory hallucinations
- Increased agitation
9000 side effects of this medication may include:
- Dry mouth
- Stomach or digestive problems
- Constipation or diarrhea
- Excessive sweating
- Noticeable changes in sex drive and / or ability
How to safely withdraw
When it is time to reduce the dose of this medication, talk to your doctor about making the reduction easier.Never stop taking Lexapro abruptly. Slowly reducing this medication in your body can reduce potential withdrawal symptoms. Possible withdrawal symptoms include:
Talk to your doctor if you experience any withdrawal effects after you stop taking this medication.
- International Civil Commission on Human Rights. (2012). Side effects of conventional psychiatric drugs .Retrieved from http://www.cchrint.org/pdfs/The_Side_Effects_of_Common_Psychiatric_Drugs.pdf
- Drugs.com. (2014). Lexapro. Retrieved from http://www.drugs.com/lexapro.html
- Medline Plus. (2014). Escitalopram. Retrieved from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603005.html.
- RxList. (2014). Lexapro. Retrieved from http://www.rxlist.com/lexapro-drug.htm
Content reviewed by James Pendleton, North Dakota.
90,000 How to take the right medication for depression
Finding the right medication for depression can be a difficult, delicate process. Some have serious medical problems, such as heart, liver, or kidney disease, which makes it unsafe to use some antidepressants. The antidepressant may not work for you or the dose of the antidepressant may not be enough; there will not be enough time to see the effect, or the side effects may be too annoying – leading to insufficient treatment.
Before you start taking antidepressants to treat depression, it is important to keep in mind:
When hospitalization is necessary for depression
The most common cases of depression – more than 90% – are treated on an outpatient basis. But, in cases of severe depression or for treatment of resistant depression, some people need to stay in the hospital for a short time. You can go to the hospital yourself. Or you may be hospitalized at the insistence of your doctor. There is a strong stigma associated with hospitalization.Many people feel ashamed, as if it were a sign that they are “crazy” or “feeble-minded.” Some people fear that being in the hospital they will definitely become abnormal …
Read the full article When hospitalization is necessary for depression >>
Only 30% of people suffering from depression achieve complete remission after taking the first course of antidepressants. These are the findings of a 2006 study funded by the US National Institutes of Health. Many patients are more likely to have to take higher doses for longer periods of time.
Some antidepressants work better for certain individuals than others. It is not uncommon to have to try different medications for depression during treatment.
- Some people need more than one drug to treat depression.
- Antidepressants must be labeled with a warning about the increased danger for suicidal thoughts and behavior in children, adolescents and young people 18-24 years old.
- Only in conjunction with your doctor, you can weigh the risks and benefits of treatment and optimize the use of the drugs that best relieve the symptoms of depression.
What is an antidepressant?
Antidepressants, sometimes in combination with psychotherapy, are often the first choice for depression. If one antidepressant is not working well, you can try another drug of the same class or drugs for a different type of depression in general. Your doctor may also try to change the dose. In some cases, your doctor may recommend more than one medication to treat your depression.
What types of antidepressants are there?
The main types of antidepressants along with brands are:
- Selective serotonin reuptake inhibitors (SSRIs) were introduced in the mid to late 1980s.This generation of antidepressants is currently the most common class used to treat depression. Examples include citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), fluoxetine (Prozac, Sarafem), vortioxetine (Brintellix), and sertraline (Zoloft). Another SSRI, Viibryd, was approved in early 2011. Side effects are usually mild, but can be long-lasting for some people. These include indigestion, sexual problems, fatigue, dizziness, insomnia, weight changes, and headaches.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a new type of antidepressant. This class includes venlafaxine (Effexor), desvelafaxine (Pristiq and Khedezla), duloxetine (Simbalta), and levomilnasirapan (Fetzima). Side effects include indigestion, insomnia, sexual problems, anxiety, dizziness, and fatigue.
- Tricyclic antidepressants (TCAs) were among the first drugs used to treat depression.Examples are amitriptyline (Elavil), desipramine (Norpramine, Pertofrane), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventil, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil). Side effects include upset stomach, dizziness, dry mouth, changes in blood pressure, changes in blood sugar, and nausea.
- Monoamine oxidase inhibitors (MAOIs) were among the earliest treatments for depression. MAOIs block the enzyme, monoamine oxidase.Examples are phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and transdermal selegiline (Emsam). Although MAO inhibitors work well, they are not prescribed very often due to the risk of dangerous reactions. They can cause serious interactions with other medicines and certain foods. Foods that can react negatively to MAO inhibitor drugs are cheese and meat.
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Other drugs for the treatment of depression:
- Bupropion (Wellbutrin, Aplenzin) differs from other antidepressants in that it affects the reuptake of norepinephrine and dopamine.Side effects are usually mild, including upset stomach, headache, insomnia, and anxiety. Bupropion is less likely to cause sexual side effects than other antidepressants.
- Mirtazapine (Remeron) is usually given at bedtime. Side effects are usually mild and include drowsiness, weight gain, increased triglyceride levels, and dizziness.
- Trazodone (Desirel) is usually taken with food to reduce the chances of an upset stomach.Other side effects include drowsiness, dizziness, constipation, dry mouth, and blurry vision.
Are other drugs used with antidepressants?
Other medicines may be prescribed in addition to antidepressants, especially in the treatment of resistant depression. Here are examples of medications that can be used to complement antidepressant therapy:
Antipsychotic medicines like Abilify (aripiprazole) and quetiapine can be used as an adjunct to antidepressant therapy.And the combination of the antipsychotic drug Zyprex and an SSRI (fluoxetine) is approved for the treatment of resistant depression.
Your doctor may recommend or prescribe other medicines or supplements approved for the treatment of depression.
How to take antidepressants correctly
- Developing good habits. Take your depression medication at the same time every day. This is easier to remember if you do it along with other activities, like having breakfast or going to bed.It’s a good thing to visit a forum about depression and connect with people who have similar problems. Such communication reminds of the tasks that lie before you.
90,000 👶 Does LSD affect an unburnt child
👶 Does LSD affect an unburned child
In the meantime, there is no need to worry about it. ”
- LSD users may behave aggressively, which could harm the child if the mother hurts herself.
- Use during pregnancy may result in low birth weight, poor muscle control, brain damage and withdrawal symptoms with frequent use.
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90,000 💊 Lexapro vs.Zoloft: what’s the difference?
With all the different depression and anxiety drugs on the market, it can be difficult to know which drug is Lexapro and Zoloft – two of the most commonly prescribed drugs for mood disorders such as depression.
These drugs are a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs). SSRIs work by increasing levels of serotonin, a substance in your brain that helps maintain your mood.Read on to find out more about the similarities and differences between Lexapro and Zoloft.
> Medicinal properties Other functions
Lexapro is indicated for the treatment of depression and generalized anxiety disorder. Zoloft is prescribed for the treatment of depression, obsessive-compulsive disorder, and several other mental health conditions. The table below compares the conditions under which each drug is approved for treatment.
|X||generalized anxiety disorder||X|
|Post Traumatic Stress Disorder (PTSD)||X|
|Social Anxiety Disorder||X|
|Premenstrual Dysphoric Dysphoric Disorder (PMDD)||X||4 Other Key Aspects Below Lexapro.|
|Lexapro||What is a generic drug?||sertraline|
|escitalopram||What forms does it come in?||oral tablet, oral solution|
|oral tablet, oral solution||What strengths does it bring?||Tablet: 25 mg, 50 mg, 100 mg solution: 20 mg / ml|
|tablet: 5 mg, 10 mg, 20 mg; solution: 1 mg / ml||Who can take it?||people 18 years and older *|
|people 12 years and older||What is the dosage?||as defined by your doctor|
|as defined by your doctor||What is the typical duration of treatment?||long-term|
|long-term||How to store this drug?||at room temperature from excess heat or moisture|
|at room temperature from excess heat or moisture||Is there a risk of exiting this drug?||yes †|
|yes †||* Excluding OCD treatment|
.If you have been taking this drug for more than a few weeks, do not stop taking it without talking to your doctor. You need to gradually taper the medication to avoid withdrawal symptoms. Cost and availability Center, availability and insurance
Both drugs are available in most pharmacies in branded and generic versions. Generics are usually cheaper than branded products. At the time this article was written, prices for the branded and generic versions of Lexapro and Zoloft were similar, according to GoodRx.com.
Health plans usually cover antidepressants such as Lexapro and Zoloft, but prefer to use generic forms.
Side effects Systemic effects
The charts below provide examples of Lexapro and Zoloft side effects. Since Lexapro and Zoloft are both SSRIs, they have the same side effects.
Common Side Effects
|X||Loss of appetite||X|
|X||apo972 9097||976 Serious 9097 975||Zoloft||suicidal actions or thoughts||X|
|X||serotonin syndrome *||X|
|X||severe allergic reactions||X 909 9076||4|
|X||seizures or seizures||X|
|X||Low weight gain or loss||X||oia (salts) in the blood||X|
|X||eye problems **||X|
|X||* Serotonin syndrome is a condition that can occur when levels of serotonin, a chemical produced your body are getting too high.Serotonin Syndrome can be life threatening.||** Eye problems may include blurry vision, double vision, dry eyes, and pressure in the eyes.|
Continue Reading: Managing Sexual Side Effects of Antidepressants
It is of concern that many people are taking antidepressants – this is weight gain. True, many antidepressants can cause weight gain, but some medications are believed to reduce weight gain, Lexapro and Zoloft are two antidepressants that may cause less weight gain.If you are concerned about this effect of taking an antidepressant, talk to your doctor.
Interaction with drugs Reactive interactions
The drug interactions between Lexapro and Zoloft are very similar. Before starting Lexapro or Zoloft, tell your doctor about all medicines, vitamins, or herbs you are taking, especially if they are listed below. This information can help your doctor prevent possible interactions.
The table below provides examples of drugs that can interact with Lexapro or Zoloft.
|Zoloft||Monoamine oxidase inhibitors (MAOIs) such as selegiline and phenelzine||x|
|nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen||x||x|
|anti-tuberculosis drugs such as buspirone and duloxetine||x||x|
|drugs for mental illness such as aripiprazole and risperidone||x||x||anti-tuberculosis drugs such as aripiprazole and risperidone||x||x||and carb amazepine||x||x|
|drugs for migraine headaches such as sumatriptan and ergotamine||x||x|
|sleeping drugs such as zolpidem||x||x||x||x||disulfiram|
|x *||irregular heartbeat drugs such as amiodarone and sotalol|
|x||* interacts if you take liquid Zoloft|
|Lexapro and Zoloft contain many of the same warnings for use with other medical conditions.For example, both drugs are pregnancy category C drugs. This means that if you are pregnant, you should only use these medicines if the benefits are greater than the risks to your pregnancy.|
The table below lists other medical conditions that you should discuss with your doctor before taking Lexapro or Zoloft.
Medical conditions to discuss with your doctor
|X||kidney problems||X||X||Read about antidepressant use and suicide risk for more information.|
|Possible Conclusion||You should not suddenly stop treatment with an SSRI such as Lexapro or Zoloft. Discontinuing these drugs suddenly can cause withdrawal symptoms.These may include:|
- sleeping problem
- If you need to stop one of these medications, talk to your doctor. They will slowly taper the dosage to prevent withdrawal symptoms. For more information, read the Dangers of Stopping an Antidepressant.
- TakeawayTalk with your doctor
- To find out more about how Lexapro and Zoloft are similar and different, talk to your doctor. They will be able to tell you if one of these drugs or another drug can help you with your mental health condition. Some questions that may be helpful to your doctor include:
- How long will it take before I feel the benefits of this medication?
- What is the right time of day for me to take this drug?
What side effects should I expect from this medication and they will go away?
Together you and your doctor can find the drug that is right for you.For other options, check out this article on the different types of antidepressants.
- Which is better for treating OCD or anxiety – Lexapro or Zoloft?
- Zoloft, but not Lexapro, is approved to help relieve symptoms of obsessive-compulsive disorder or OCD. OCD is a common and long-term condition. This leads to uncontrollable thoughts and encourages repeating certain behaviors over and over. In terms of anxiety, Zoloft is approved for the treatment of social anxiety disorder and is sometimes used unlabeled for the treatment of generalized anxiety disorder (GAD).Lexapro is approved for the treatment of GAD and can be used off-label for the treatment of social anxiety disorder and panic disorder. If you have OCD or anxiety, talk to your doctor about which drug might be best for you.
Healthline Medical TeamAnswers represents the opinions of our medical experts. All content is strictly informative and should not be construed as medical advice.
How to write a complaint to the Ministry of Health
If you received poor quality medical care or was not provided at all, you can file a complaint against the medical institution or the action (inaction) of the doctor.
A complaint against a doctor working in a public medical institution is tantamount to a complaint against the medical institution itself. Therefore, it makes sense to first file a complaint with the management of the department or hospital where this doctor works.
Contact details of most of the medical institutions in the city of Rostov-on-Don can be found on our website, or directly on the website of the medical institution.
If the clinic’s management has not taken any steps, you can file a complaint with other authorities.In this case, we are considering filing a complaint with the Ministry of Health of the Russian Federation through the citizens’ appeal form on the website of the Ministry of Health at rosminzdrav.ru. The paper appeal is filled out in the same way.
An appeal sent directly to the Ministry of Health of the Russian Federation will be forwarded below in the instance to the body directly managing these health facilities. Citizens’ applications received in electronic form, no later than within three days, are registered and also sent to those federal executive authorities, which are directly in charge of resolving the sent issue.
How to write a complaint to the Ministry of Health correctly
Like any other bureaucratic document, the complaint must meet the following requirements:
- Be sure to contain your personal data – name, address, phone number for contact. The Ministry of Health of Russia is not able to send a response to requests with incomplete or inaccurate information about the sender.
- Be sure to include information about who or what you are complaining about. For a medical institution, this is a legal address.For a doctor, this is a name, a place of work, an office in which he accepts. The name of the doctor can be omitted if you do not know him. However, then it is imperative to indicate his place of work and office, as well as the time of your visit.
- Summarize the problem. Without emotions, only the essence of the problem and claims without harsh expressions, abuse, and even more so threats. Also, an indication of a specific article of the law that the doctor or healthcare facility violated will be a huge plus.
- State what exactly you are seeking with your complaint.
- End the complaint by asking you to understand the situation and take the necessary action, and also provide you with an answer to the decision.
- There is no need to give a personal assessment of the doctor or clinic in the complaint description.
- The complaint should not be very long. Respect the employees of the Ministry of Health.
Your complaint will definitely be checked. The procedure for considering citizens’ appeals is regulated by Federal Law of 02.05.2006 No. 59-FZ “On the Procedure for Considering Citizens’ Applications in the Russian Federation”, as well as Resolution of the Government of the Russian Federation No. 452 dated July 28, 2005 “On Model Regulations for the Internal Organization of Federal Executive Bodies”.
An example of how it is unnecessary to write a complaint
Hello! I want to complain to you about a doctor who refused to provide me with medical assistance. A couple of weeks ago I got sick and went to my clinic for help. The doctor had a huge queue, he did not take me for a very long time, and when my turn came, he just left the office, saying that he would be back in a couple of minutes.Returning an hour later, he said that he would not receive anyone else, because already half 6. Although until the end of the working day there was still half an hour! What is this disgrace !? Where is the hospital management looking !? Figure it out immediately!
An example of the correct writing of a complaint
From (your full name), residing at (full address with zip code), mobile phone: ——————-.