The antidepressant action of escitalopram is presumably linked to the potentiation of serotonergic activity in the central nervous system (CNS) resulting from its inhibitory effect on the reuptake of 5-HT from the synaptic cleft. Escitalopram is the S-enantiomer of the racemate citalopram and is the enantiomer to which the therapeutic activity is attributed. Pharmacological studies have shown that the R-enantiomer is not inert but counteracts the serotonin-enhancing properties of the S-enantiomer in citalopram. Escitalopram has high affinity for the primary binding site and an allosteric modulating effect on the serotonin transporter.
Esipram 10 Tablet
Adults: The initial dose of Escitalopram Oxalate is 10 mg once daily. (A fixed dose trial of Escitalopram Oxalate demonstrated the effectiveness of both 10 mg and 20 mg of Escitalopram Oxalate, but failed to demonstrate a greater benefit of 20 mg over 10 mg.)
If the dose is increased to 20 mg, this should occur after a minimum of one week.
Panic disorder: Adult over 18 years, initially 5 mg once daily increased to 10 mg daily after 7 days; max. 20 mg daily; elderly initially half adult dose, lower maintenance dose may be sufficient;
Social anxiety disorder: Adult over 18 years, initially 10 mg once daily adjusted after 2-4 weeks; usual dose 5-20 mg daily.
Elderly: A single oral dose of 10 mg/day is the recommended dose for most elderly patients. Administered in excess recommended dose has not been yet established.