What is the recommended dosing for Escitalopram (Lexapro)?

From the Guidelines

Lexapro (escitalopram) should be dosed at 10 to 20 mg per day for adults with depression or anxiety disorders. The dosing range for escitalopram is based on the study by 1, which provides a comprehensive overview of commonly used antidepressant medications, including their dosage ranges. According to this study, the recommended dosage range for escitalopram is 10 to 20 mg per day, with no requirement to decrease the dose in patients with renal or hepatic disease. Some key points to consider when prescribing escitalopram include:

• Starting at 10 mg once daily for adults with depression or anxiety disorders
• Option to increase to 20 mg daily after at least one week if needed
• No dose adjustment required for patients with renal or hepatic disease
• Potential side effects include nausea, headache, insomnia, and sexual dysfunction
• Importance of regular follow-up with a healthcare provider to monitor effectiveness and adjust dosing as needed. It's also worth noting that escitalopram is considered a preferred agent due to its favorable adverse effect profile, as mentioned in the study by 1.

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. 2

From the Research

Recommended Dosing for Escitalopram (Lexapro)

The recommended dosing for Escitalopram (Lexapro) can be found in several studies, including:

• A 12-week, open-label, flexible-dose, pilot trial 3 which used escitalopram 10 to 20 mg/d for moderate to marked comorbid depression and anxiety in elderly patients.
• A review of escitalopram for the management of major depressive and anxiety disorders 4 which states that escitalopram 10 or 20 mg/day produced significant improvements in patients with major depressive disorder.
• A review of escitalopram for the management of major depressive disorder in adults 5 which demonstrates that escitalopram is effective at a dose of 10 to 20 mg/day.

Key Findings

Some key findings related to the dosing of escitalopram include:

• Escitalopram has linear pharmacokinetics, with plasma levels increasing proportionately and predictably with increased doses 6.
• The half-life of escitalopram is 27 - 32 h, consistent with once-daily dosing 6.
• Escitalopram has a low potential for drug-drug interactions due to its negligible effects on cytochrome P450 drug-metabolising enzymes in vitro 6.

Dosing Considerations

Some considerations for dosing escitalopram include:

• The most common adverse events associated with escitalopram include nausea, insomnia, ejaculation disorder, diarrhoea, dry mouth and somnolence 6.
• Escitalopram has a predictable tolerability profile with generally mild to moderate and transient adverse events 5.