From the FDA Drug Label
Escitalopram tablets should be administered once daily, in the morning or evening, with or without food. The recommended dose of Escitalopram tablets is 10 mg once daily. If the dose is increased to 20 mg, this should occur after a minimum of three weeks for adolescents and one week for adults. 10 mg/day is the recommended dose for most elderly patients and patients with hepatic impairment.
The recommended dosing for escitalopram (Lexapro) is:
- Initial Treatment: 10 mg once daily for adolescents and adults with Major Depressive Disorder, and for adults with Generalized Anxiety Disorder.
- Dose Increase: If necessary, the dose can be increased to 20 mg after a minimum of three weeks for adolescents and one week for adults.
- Special Populations: 10 mg/day is recommended for most elderly patients and patients with hepatic impairment. 1
From the Research
The recommended dosing for escitalopram (Lexapro) typically starts at 10 mg once daily for adults with depression or anxiety disorders, with the option to increase to 20 mg daily after a minimum of one week if needed. This recommendation is based on the most recent and highest quality study available, which suggests that escitalopram is effective and well-tolerated in the treatment of depression and anxiety disorders 2.
Key Considerations
- For elderly patients or those with hepatic impairment, starting at 5 mg daily is advised, with a maximum of 10 mg daily, as they may be more susceptible to the side effects of escitalopram 3.
- Adolescents (12-17 years) with depression usually start at 10 mg daily, as the efficacy and safety of escitalopram in this age group have been established 4.
- Escitalopram should be taken at the same time each day, with or without food, and should not be stopped abruptly as this may cause withdrawal symptoms 5.
- Patients should continue treatment for at least 6 months after symptom improvement to prevent relapse, as the therapeutic effects of escitalopram may take 2-4 weeks to become noticeable 6.
Common Side Effects
- Nausea
- Insomnia
- Sexual dysfunction
- Increased anxiety during the first few weeks of treatment These side effects are generally mild and transient, but may require dose adjustment or additional treatment in some cases 2.
Special Considerations
- Escitalopram has a low potential for drug-drug interactions, due to its negligible effects on cytochrome P450 drug-metabolising enzymes 3.
- The medication works by increasing serotonin levels in the brain, which helps regulate mood, and has been shown to be effective in treating generalised anxiety disorder, panic disorder, and social anxiety disorder 2.