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In some casesa patient already receiving Lexapro therapy may require urgent treatment with linezolid or intravenous methylene blueIf acceptable alternatives to linezolid or intravenous methylene blue treatment are not available and the potential benefits of linezolid or intravenous methylene blue treatment are judged to outweigh the risks of serotonin syndrome in a particular patientLexapro should be stopped promptlyand linezolid or intravenous methylene blue can be administeredThe patient should be monitored for symptoms of serotonin syndrome for 2 weeks or until 24 hours after the last dose of linezolid or intravenous methylene bluewhichever comes firstTherapy with Lexapro may be resumed 24 hours after the last dose of linezolid or intravenous methylene bluesee WARNINGS AND PRECAUTIONS

Escitalopram is used to treat depression and anxietyIt works by helping to restore the balance of a certain natural substanceserotoninin the brainEscitalopram belongs to a class of drugs known as selective serotonin reuptake inhibitorsSSRIIt may improve your energy level and feelings of well-being and decrease nervousness.

Some young people have thoughts about suicide when first taking an antidepressantYour doctor should check your progress at regular visitsYour family or other caregivers should also be alert to changes in your mood or symptoms.

Convulsionsincluding grand mal convulsionshave been reported with racemic citalopram.

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To reduce your risk of side effectsyour doctor may direct you to start taking this drug at a low dose and gradually increase your doseFollow your doctor’s instructions carefullyDo not increase your dose or use this drug more often or for longer than prescribedYour condition will not improve any fasterand your risk of side effects will increaseTake this medication regularly to get the most benefit from itTo help you remembertake it at the same time each day.

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Lexapro should be administered once dailyin the morning or eveningwith or without food.

General Disorders and Administration Site Conditionsabnormal gaitastheniaedemafallfeeling abnormalmalaise.

Decreased appetite and weight loss have been observed in association with the use of SSRIsConsequentlyregular monitoring of weight and growth should be performed in children and adolescents treated with an SSRI such as Lexapro.

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A weight gain can be a common side effect of the selective serotonin reuptake inhibitors ssris , the class of drugs that includes lexapro escitalopram .

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Combined administration of racemic citalopram40 mg/day for 14 daysand carbamazepinetitrated to 400 mg/day for 35 daysdid not significantly affect the pharmacokinetics of carbamazepinea CYP3A4 substrateAlthough trough citalopram plasma levels were unaffectedgiven the enzyme-inducing properties of carbamazepinethe possibility that carbamazepine might increase the clearance of escitalopram should be considered if the two drugs are coadministered.

Escitalopram is metabolized to S-DCT and S-didemethylcitalopramS-DDCTIn humansunchanged escitalopram is the predominant compound in plasmaAt steady statethe concentration of the escitalopram metabolite S-DCT in plasma is approximately one-third that of escitalopramThe level of S-DDCT was not detectable in most subjectsIn vitro studies show that escitalopram is at least 7 and 27 times more potent than S-DCT and S-DDCTrespectivelyin the inhibition of serotonin reuptakesuggesting that the metabolites of escitalopram do not contribute significantly to the antidepressant actions of escitalopramS-DCT and S-DDCT also have no or very low affinity for serotonergic5-HT 1-7or other receptors including alphaand beta-adrenergicdopamineD 1-5histamineH 1-3muscarinicM 1-5and benzodiazepine receptorsS-DCT and S-DDCT also do not bind to various ion channels including NaKCl and Cachannels.

Lexapro has not been systematically evaluated in patients with a recent history of myocardial infarction or unstable heart diseasePatients with these diagnoses were generally excluded from clinical studies during the product’s premarketing testing.

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