From the Research
Escitalopram can potentially cause esophageal erythema (mild redness) observed during gastroscopy, and the underlying mechanism is related to its effects on gastrointestinal motility and secretion as a selective serotonin reuptake inhibitor (SSRI). As a SSRI, escitalopram increases serotonin levels, which can affect gastrointestinal motility and secretion, influencing acid production and blood flow to the gastric mucosa 1. Additionally, escitalopram may reduce prostaglandin synthesis, which normally protects the gastric mucosa, leading to increased vulnerability to irritation 2. Some patients also experience reduced gastric emptying while taking SSRIs, allowing stomach acid to remain in contact with the esophagus for longer periods, potentially causing erythema. The most recent and highest quality study on the use of escitalopram in functional gastrointestinal disorders found that it could be a safe and effective treatment, but also highlighted the importance of managing factors leading to poor compliance 3. If you're experiencing symptoms along with esophageal erythema, discuss with your doctor about possibly adding a proton pump inhibitor like omeprazole or pantoprazole for gastric protection, adjusting your escitalopram dosage, or considering an alternative antidepressant with fewer gastrointestinal effects. Key points to consider:
- Escitalopram's effects on serotonin levels and gastrointestinal motility and secretion
- Potential reduction in prostaglandin synthesis and increased vulnerability to irritation
- Importance of managing factors leading to poor compliance
- Possible addition of a proton pump inhibitor or adjustment of escitalopram dosage.