Escitalopram for the treatment of major depression and anxiety disorders

Abstract

Escitalopram is the S-enantiomer of the selective serotonin reuptake inhibitor (SSRI) citalopram, which contains equal amounts of the S- and R-forms in a racemic mixture. Escitalopram is the most selective SSRI, with almost no significant affinity to other tested receptors. It has been demonstrated that it is escitalopram that carries the therapeutic potential of citalopram, and has statistically superior and clinically relevant properties compared with citalopram. Escitalopram is at least as effective in the treatment of depression and anxiety as other SSRIs, as well as venlafaxine, bupropion and duloxetine. Owing to multiple metabolic degrading pathways, the clinically relevant interactions of escitalopram with other drugs are minimal. Compared with other antidepressants, escitalopram is generally better tolerated, its onset of action is relatively fast, and its use may have cost–effectiveness and cost–utility advantages. Escitalopram is an effective first-line option in the management of patients with major depression, including severe forms, and various anxiety disorders.

Keywords::

• anxiety
• chiral stereoisomer
• depression
• enantiomer
• escitalopram

Financial & competing interests disclosure

This work was supported by the grant MZ0PCP2005 from the Ministry of Health, Czech Republic. The first author (Höschl) is a faculty member of Lundbeck Psychiatric Institute, which is supported by the Lundbeck International Neuroscience Foundation. Both authors have no other affiliations or financial interests that might affect the conduct or reporting of the work submitted. No third party took part in preparing this manuscript either directly or indirectly, except editors. The structure of the text is based on a review published 4 years ago by the second author.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.