Precautions and Warnings for Escitalopram
Some people who take antidepressants, such as escitalopram, may have an increased risk of suicidal thinking or suicidal behavior. A few other precautions and warnings for escitalopram include potential drug interactions; the safety of taking escitalopram while pregnant or nursing; and the risk of seizures, allergic reactions, or withdrawal symptoms in some people taking this medicine. You should make sure to talk with your healthcare provider about any escitalopram precautions and warnings that may apply to you.
- Bipolar disorder or a family history of bipolar disorder (manic-depression)
- A history of suicide attempts or suicidal thoughts
- A recent history of a heart attack (or if you have unstable heart disease)
- Seizures or epilepsy
- Liver disease, including liver failure or cirrhosis
- Any allergies, including allergies to food, dyes, or preservatives.
- Are pregnant or thinking of becoming pregnant
- Are breastfeeding
- Drink alcohol regularly.
Antidepressants (including escitalopram) may increase the risk of suicidal thinking or suicidal behavior in children, teenagers, and adults (see Antidepressants and Suicide for more information). Therefore, if you notice any changes in symptoms or new symptoms while taking escitalopram, talk with your healthcare provider immediately. Some of these symptoms may include anxiety, hostility, agitation, panic, restlessness, hallucinations, extreme hyperactivity, and suicidal thinking or suicidal behavior (see Lexapro and Suicide for more information).
Before prescribing escitalopram for depression, your healthcare provider should make sure that you do not have bipolar disorder (instead of depression). Sometimes, the symptoms of bipolar disorder and depression are very similar, and escitalopram can cause problems in people with bipolar disorder.
- Antidepressants can cause a group of dangerous symptoms known as serotonin syndrome. Taking escitalopram with other medications that affect serotonin can increase this risk. These other medications include other antidepressants, triptans (migraine medications), and several other medications (see Drug Interactions With Escitalopram for more information). Contact your healthcare provider immediately if you have any possible symptoms of serotonin syndrome, including:
Seeing or hearing things that are not really there (hallucinations)
Fast heartbeat (tachycardia)
You should tell your healthcare provider if you develop a rash, hives, or other allergic reactions while taking escitalopram.
If you are stopping escitalopram, you should be monitored by a healthcare professional for escitalopram withdrawal symptoms. If you do develop any symptoms of escitalopram withdrawal, such as irritability, anxiety, confusion, headache, lethargy, or insomnia, your healthcare provider may slow down the rate at which the escitalopram is stopped (see Lexapro Withdrawal).
- Escitalopram may cause bleeding in the stomach or intestines. This risk is increased in those who are also taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen. Symptoms of gastrointestinal bleeding may include:
- Bright red blood coating the stool
- Dark blood mixed with the stool
- Black or tarry stool
- Bright red blood in vomit
- Vomit that has the appearance of coffee grounds.
If you experience any of these symptoms, call your healthcare provider.
- If you are elderly or taking a diuretic, escitalopram could cause low salt levels in the blood (hyponatremia). This side effect generally subsides when escitalopram is stopped.
- Escitalopram may affect your ability to perform complex tasks requiring mental and motor skills. Therefore, it is recommended that you take some time to get to know how escitalopram affects you before doing any activities that require mental or motor concentration (such as driving a car or operating machinery).
- Escitalopram can interact with certain medications (see Drug Interactions With Escitalopram).
- Escitalopram is considered a pregnancy Category C medication. This means that escitalopram may not be safe to use during pregnancy. Prior to taking escitalopram, talk with your healthcare provider about the risks and benefits of using escitalopram during pregnancy (see Lexapro and Pregnancy for more information).
- Escitalopram passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about using escitalopram (see Lexapro and Breastfeeding for more information).
If you are over 65 years old, your healthcare provider may choose to make necessary dosing adjustments with caution.