Talk:Escitalopram

Alcohol and Escitalopram
Could we get some information/studies/details on how escitalopram and alcohol might interact, and whether they do in fact interact at all? — Preceding unsigned comment added by 184.45.25.61 (talk) 18:57, 16 March 2017 (UTC)

Antidepressant utility "controversial" for moderate depression?
I am concerned that the use of the word "controversial" in second sentence of this article is unwarranted.
 * The utility of antidepressant drugs in the treatment of mild-to-moderate depression is itself controversial.

If you read the 2010 meta-analysis cited here, it doesn't look at Escitalopram, but rather at (only) 3 studies of one older SSRI, paroxetine, and three studies of the tricycle (TCA), imipramine, an old kind of antidepressant medication (ADM) that is hardly used anymore. The JAMA article also mentions several studies of ADM for dysthymia (a less severe, but chronic, depression), that show ADM demonstrates a “true” drug effect in patients with mild or moderate depressive symptoms.

It is my opinion that if scientific doubt about the efficacy of any particular SSRI were to be mentioned, it might be better phrased with less arousing language, such as is used in the third paragraph of the Selective serotonin reuptake inhibitor article:


 * The efficacy of SSRIs in mild or moderate cases of depression has been disputed.[4][5][6]

There are plenty of good articles expressing doubts and worries about the explosion of use of SSRIs, such as Percentage of Americans on Antidepressants Nearly Doubles, 6Nov2015. But one in three adults will experience an episode of Major Depressive Disorder (MDD), so IMO, it'd be better just to omit this whole sentence from the article, than leave it there as is, like a little IED that sows doubt in the mind of some poor soul struggling to take the advice of their medical professional.

For convenience, here are the two relevant sections of the JAMA meta-analysis that I referred to:

''[...] Three studies utilized the tricyclic antidepressant (TCA) imipramine and three utilized the selective serotonin reuptake inhibitor (SSRI) paroxetine. [...] The pooled sample used in the current analyses included 434 patients in the ADM group and 284 patients in the placebo group.''

''[...] Several studies have demonstrated that ADM is superior to placebo for patients diagnosed with dysthymia, a condition partly defined by lower symptom levels relative to MDD. The dysthymia studies indicate that ADM can produce a “true” drug effect in patients with mild or moderate depressive symptoms. However, dysthymia is by definition a chronic condition, and chronicity is known to be associated with poor response to placebo''.

Permacultura (talk) 03:29, 9 March 2017 (UTC)


 * Should probably be removed from the lead. The issue is too complicated to explain properly there and is done better later on in the article. PriceDL (talk) 08:56, 9 March 2017 (UTC)

External links modified
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Proposed changes
·Information to be added: Suicide/suicidal thoughts or clinical worsening.

Depression is associated with an increased risk of suicidal thoughts, self harm and suicide (suicide-related events). This risk persists until significant remission occurs. As improvement may not occur during the first few weeks or more of treatment, patients should be closely monitored until such improvement occurs. It is general clinical experience that the risk of suicide may increase in the early stages of recovery. Patients with a history of suicide-related events or those exhibiting a significant degree of suicidal ideation prior to commencement of treatment are known to be at greater risk of suicidal thoughts or suicide attempts, and should receive careful monitoring during treatment.

A meta-analysis of placebo-controlled clinical studies of antidepressants in adult patients with psychiatric disorders showed an increased risk of suicidal behaviour with antidepressants compared to placebo, in patients less than 25 years old. Close supervision of patients and in particular those at high risk should accompany treatment especially in early treatment and following dose changes. Patients (and caregivers of patients) should be alerted to the need to monitor for any clinical worsening, suicidal behaviour or thoughts and unusual changes in behaviour and to seek medical advice immediately if these symptoms present.

·Explanation of issue: At the top of the page, there is a mention to serious side effects related to suicide ("More serious side effects may include suicide in people under the age of 25"). This mention is a section of the SmPC and miss essential information related to Suicide/suicidal thoughts clinical worsening. It is important to include the full class label related to the SmPC as stated above with the below reference.

·References supporting change: https://www.medicines.ie/medicines/lexapro-5-mg-tablets-34771/smpc

AudreyDufour (talk) 10:17, 5 February 2020 (UTC)

Reply 5-FEB-2020
Regards, Spintendo  20:27, 5 February 2020 (UTC)
 * Wikipedia is WP:NOT a package insert, and thus this expanded information from the product's PI is not necessary here in full. Several links to monographs and such are already included elsewhere in the article, such that expanding the text through this edit request allows no more information than what is already provided for the reader to access, if desired.

Chemistry section
The chemistry section appears to be incomplete. 67.163.170.208 (talk) 10:00, 9 August 2023 (UTC)

Manufacturer
Anybody knows who is a manufacturer? Irochka1428 (talk) 17:21, 19 October 2023 (UTC)