This page describes pharmacological agents that may have legal restrictions, side effects, and drug interactions in your jurisdiction. Information is for educational research only — consult a clinician before considering any compound.
Escitalopram
"Cleanest" SSRI — most selective SERT binding, fewest CYP interactions, generally best-tolerated.
Aliases (2)
Overview
What is Escitalopram?
Escitalopram (Lexapro) is the S-enantiomer of citalopram and one of the most selective SSRIs available. FDA-approved for major depression and generalized anxiety disorder; widely prescribed worldwide.
Key Benefits
Effective for depression, anxiety disorders (GAD, panic, OCD off-label), with a generally favorable side-effect profile compared to older SSRIs. Cleaner pharmacology than racemic citalopram, fewer QT concerns at therapeutic doses.
Mechanism of Action
Selectively inhibits the serotonin transporter (SERT), increasing synaptic serotonin. Allosterically binds a secondary SERT site that may potentiate primary inhibition. Minimal off-target binding.
Pharmacokinetics
What to Expect
- Week 1Tolerability and dose-response.
- Week 2-4Early effect window.
- Week 4-8Peak benefit assessment.
- Week 8+Cycle decision point.
Side Effects & Safety
- Common (>10%): Sexual dysfunction (30-60%), nausea early, somnolence, fatigue, ejaculation delay.
- Less common (1-10%): Insomnia, weight gain (modest, long-term), sweating, bruxism.
- Rare-serious (<1%): Serotonin syndrome, hyponatremia, QT prolongation (FDA limited to 20mg), suicidal ideation <25 yo (FDA black box).
- Specific watch periods: First 4 weeks for activation; baseline + repeat ECG if cardiac risk factors.
References
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