Side Effects of escitalopram: A Synthesis of Findings from 26 Studies

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Original Abstract of the Article

Main Research Findings

Escitalopram is an effective treatment for anxiety disorders in children, but it can cause gastrointestinal side effects. 22 showed that escitalopram-treated youth had transient changes in nausea/vomiting and total upper gastrointestinal symptoms during the first two weeks of treatment. In addition to this, 10 indicates that escitalopram may cause uterine bleeding in postmenopausal women. Further, 9 reports that escitalopram can cause angioedema.

2 suggests that side effects of antidepressants, including escitalopram, can impact the prognosis of successful treatment outcome in people with major depressive disorder. 19 is a study that evaluated side effects of SSRIs such as sertraline, escitalopram, and fluoxetine in a naturalistic treatment setting, and proposed a better way to evaluate SSRI side effects. Moreover, 26 demonstrates that antidepressants can be toxic to male reproductive system cells, and the effects may reach the cells of spermatogenesis process.

Reasons for Side Effects

Side effects of escitalopram are thought to occur by inhibiting the reuptake of serotonin. Serotonin is a neurotransmitter that affects mood, sleep, appetite, and sexual function. Escitalopram inhibits the reuptake of serotonin, increasing the concentration of serotonin in the brain. This increase in serotonin concentration is thought to cause side effects such as gastrointestinal symptoms, decreased sexual function, nervousness, and anxiety. 10 suggests that serotonin may affect blood clotting, and this is considered one of the reasons for uterine bleeding in postmenopausal women.

Common Side Effects

Gastrointestinal Symptoms

Escitalopram can cause gastrointestinal side effects. The most common side effects include nausea, vomiting, diarrhea, and constipation. 22 showed that these symptoms increased temporarily in the first two weeks. However, according to the study results, there was no difference in the frequency or severity of gastrointestinal symptoms between escitalopram and placebo. 22

Decreased Sexual Function

Escitalopram can cause decreased sexual function. The most common side effects include decreased libido, erectile dysfunction, and ejaculatory dysfunction. 10 showed that more than 70% of patients treated with sertraline, citalopram or paroxetine experience sexual side effects, while escitalopram and fluvoxamine yield the lowest degree of sexual dysfunction within the group.

Nervousness

Escitalopram can cause nervousness. The most common side effects include anxiety, insomnia, tremor, and sweating.

Other Side Effects

Escitalopram can also cause side effects such as weight gain, fatigue, dry mouth, headache, and dizziness. 2 suggests that the burden of side effects may negatively impact treatment outcome. Also, 26 suggests that taking antidepressants may have toxic effects on the cells of the spermatogenesis process. These side effects usually subside within a few weeks of starting treatment.

Measures to Counter Side Effects

Measures to Counter Gastrointestinal Symptoms

Dietary therapy and lifestyle changes can be made to reduce gastrointestinal symptoms. For example, eating small amounts of food slowly, avoiding caffeine and alcohol, and avoiding stress. 22 suggested that assessing gastrointestinal symptoms prior to pharmacotherapy and discussing factors that increase (or decrease) the likelihood of transient SSRI-related symptoms in youth may decrease patient uncertainty related to side effects and decrease medication-related anxiety.

Measures to Counter Decreased Sexual Function

To reduce decreased sexual function, methods such as reducing the dose of the drug, changing to another drug, or adding another drug can be used. 10 suggested that a small group of patients experience post-SSRI dysfunction, in which sexual dysfunction persists after treatment termination.

Measures to Counter Nervousness

To reduce nervousness, you can engage in relaxing activities, ensure adequate sleep, and avoid caffeine and alcohol.

Comparison Between Studies

Commonalities Between Studies

Many studies have shown that escitalopram can cause side effects such as gastrointestinal symptoms, decreased sexual function, and nervousness. Also, these side effects usually subside within a few weeks of starting treatment. Many studies have shown that escitalopram is an effective drug, but it is important to understand the risks of side effects.

Differences Between Studies

Some studies have suggested that escitalopram may cause uterine bleeding in postmenopausal women, and 10 is one example. Also, 9 showed that escitalopram may cause angioedema. As these side effects are very rare, these studies suggest that further research is needed to fully understand the side effects of escitalopram.

Points to Note in Applying This to Real Life

Escitalopram is an effective drug, but it is important to understand the risks of side effects. If you experience side effects while taking escitalopram, consult your doctor. Your doctor will be able to take appropriate measures to reduce the side effects. Also, before taking escitalopram, consult your doctor about your medical history and any medications you are taking. Especially if you are pregnant or breastfeeding, you should consult your doctor.

Limitations of Current Research

There is still not enough research on the side effects of escitalopram. In particular, research on long-term side effects is lacking. Research on risk factors and mitigation measures for side effects is also lacking. Furthermore, there is a lack of research on the side effects of escitalopram in children and the elderly.

Directions for Future Research

Further research is needed on the side effects of escitalopram. In particular, research is needed on long-term side effects, risk factors and mitigation measures, and side effects in children and the elderly. These studies are important for gaining a deeper understanding of the safety of escitalopram and for providing more appropriate treatment for patients.

Conclusion

Escitalopram is an effective treatment for anxiety disorders. However, it can cause side effects such as gastrointestinal symptoms, decreased sexual function, and nervousness. It is important to understand the risks of side effects and consult your doctor. Further research on escitalopram is needed, which will allow us to provide safer and more effective treatments.

Literature analysis of 26 papers
Positive Content
17
Neutral Content
1
Negative Content
8
Article Type
4
2
3
3
20
1.

Common selective serotonin reuptake inhibitor side effects in older adults associated with genetic polymorphisms in the serotonin transporter and receptors: data from a randomized controlled trial.

Author: GarfieldLauren D, DixonDavid, NowotnyPetra, LotrichFrancis E, PollockBruce G, KristjanssonSean D, DoréPeter M, LenzeEric J

Antidepressant side effects

This study investigated the relationship between antidepressant side effects and genetic variations in the serotonin system in older adults experiencing anxiety. The research aimed to understand the impact of genetic variations on the effectiveness and tolerability of escitalopram, a selective serotonin reuptake inhibitor, in this population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

2.

Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report.

Author: BraundTaylor A, TillmanGabriel, PalmerDonna M, GordonEvian, RushA John, HarrisAnthony W F

Depression treatment
Side effects
Treatment outcome

This study looks at the frequency, intensity, and burden of side effects associated with antidepressant medications in people with major depressive disorder (MDD). The study found that the burden of side effects was associated with poorer treatment outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Induced Depressive Disorder Following the First Dose of COVID-19 Vaccine.

Author: RammouzIsmail, DoufikJalal, AalouaneRachid, BoujrafSaïd

Depressive episode

This paper reports a case of acute depressive episode occurring 24 hours after receiving the first dose of the BNT162b2 mRNA COVID-19 vaccine. This case highlights the importance of recognizing potential psychiatric side effects of vaccines and underscores the need for further research in this area.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

4.

Psychological and pharmacological interventions for depression in patients with coronary artery disease.

Author: TullyPhillip J, AngSer Yee, LeeEmily Jl, BendigEileen, BauereißNatalie, BengelJürgen, BaumeisterHarald

Reduced depression symptoms
Further research needed

Psychological interventions may reduce depression symptoms in patients with coronary artery disease (CAD) and depression, while pharmacological interventions may lead to a large reduction in depression symptoms and a moderate to large increase in depression remission. However, the certainty of evidence is low for most outcomes, and further research is needed to identify the most effective approaches for improving depression in this patient population.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

Pharmacogenetics and Pain Treatment with a Focus on Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and Antidepressants: A Systematic Review.

Author: ZobdehFarzin, EremenkoIvan I, AkanMikail A, TarasovVadim V, ChubarevVladimir N, SchiöthHelgi B, MwinyiJessica

Ibuprofen myopathy
Ibuprofen nephrotoxicity
Selective serotonin reuptake inhibitor bleeding
Serotonin syndrome

This systematic review highlights the need for more research on the impact of pharmacogenetics on the efficacy and safety of NSAIDs and antidepressants in pain treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Two children exhibiting social withdrawal, school refusal, and underlying generalized anxiety disorder successfully treated using a selective serotonin reuptake inhibitor.

Author: YamadaNaoki, NakadoiYoshihiro, FukumaRyosuke, OhmoriTetsuro

GAD treatment
School refusal improvement
Social withdrawal improvement
SSRI risk in young patients

This study reports two cases of 10-year-old patients with generalized anxiety disorder (GAD) who were successfully treated with escitalopram. The patients experienced improvement in social withdrawal and school refusal. The findings suggest that SSRIs may be effective in treating GAD in young patients, but careful monitoring is required due to potential side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

[Sexual side effects from treatment with SSRI].

Author: HuttersCecilie Lybeck, GiraldiAnnamaria

SSRI efficacy
Post-SSRI dysfunction
Sexual dysfunction

Selective serotonin reuptake inhibitors (SSRIs) can cause sexual dysfunction. More than 70% of patients treated with sertraline, citalopram or paroxetine experience sexual side effects. This review suggests management strategies including dose reduction, change of medication, and add-on treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Danish

11.

Antidepressant side effects and their impact on treatment outcome in people with major depressive disorder: an iSPOT-D report.

Author: BraundTaylor A, TillmanGabriel, PalmerDonna M, GordonEvian, RushA John, HarrisAnthony W F

Depression treatment
Side effects
Treatment outcome

This study looks at the frequency, intensity, and burden of side effects associated with antidepressant medications in people with major depressive disorder (MDD). The study found that the burden of side effects was associated with poorer treatment outcomes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Inclusion of genetic variants in an ensemble of gradient boosting decision trees does not improve the prediction of citalopram treatment response.

Author: ShumakeJason, MallardTravis T, McGearyJohn E, BeeversChristopher G

Depression treatment

This study used genome-wide genetic variation and machine learning to predict response to the antidepressant citalopram in the STAR*D trial. While including genetic information did not improve prediction accuracy compared to using clinical predictors alone, the study provides valuable insights for precision medicine efforts.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

14.

Sexual function improves as depressive symptoms decrease during treatment with escitalopram: results of a naturalistic study of patients with major depressive disorder.

Author: WeberSophia, FrokjaerVibe Gedsoe, ArmandSophia, NielsenJulie Helmer, KnudsenGitte Moos, JoergensenMartin Balslev, StenbaekDea Siggaard, GiraldiAnnamaria

Sexual function improvement
MDD
SSRI
Sexual dysfunction

Sexual dysfunction was associated with major depressive disorder (MDD) and improved in parallel with depression symptoms during treatment with escitalopram.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Selective Serotonin Reuptake Inhibitors within Cells: Temporal Resolution in Cytoplasm, Endoplasmic Reticulum, and Membrane.

Author: NicholsAaron L, BlumenfeldZack, LuebbertLaura, KnoxHailey J, MuthusamyAnand K, MarvinJonathan S, KimCharlene H, GrantStephen N, WaltonDavid P, CohenBruce N, HammarRebekkah, LoogerLoren, ArturssonPer, DoughertyDennis A, LesterHenry A

Mood stabilization
Discontinuation syndrome
Side effects

This study investigated the cellular and subcellular pharmacokinetic properties of two selective serotonin reuptake inhibitors (SSRIs), escitalopram and fluoxetine, in cultured neurons and mammalian cells. The findings suggest that SSRIs rapidly enter neurons and accumulate in membranes, providing insights into their potential mechanisms of action.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

A personal account of reducing and stopping antidepressant treatment.

Author: BaldwinDavid S

Improved productivity
Increased confidence
Reduced acoustic problems
Reduced back pain
Apathy
Puzzling symptoms

Escitalopram, an antidepressant, showed positive effects on productivity, social confidence, and back pain. However, withdrawal symptoms may occur upon dosage reduction.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Abnormal Uterine Bleed in a Postmenopausal Woman With the Use of Escitalopram.

Author: YadavAkshita, BharatBrandon S, MontroseStephanie

Depression treatment
Uterine bleeding

This case study examines an instance of uterine bleeding in a postmenopausal woman after starting an antidepressant. The medication was the only noticeable change in her daily routine before the onset of bleeding, making it the likely cause. This case study demonstrates the role of serotonin in potentiating the coagulation cascade.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

20.

Escitalopram-Induced Skin Rash: Dermatitis Medicamentosa.

Author: GodiSangha M, SinghLokesh K

Efficacy
Safety
Tolerability
Rash

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressants. While generally safe, this study highlights the rare occurrence of skin rashes associated with escitalopram, emphasizing the importance of reporting side effects.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

23.

Systematic review and meta-analysis on the therapeutic reference range for escitalopram: Blood concentrations, clinical effects and serotonin transporter occupancy.

Author: EichentopfLuzie, HiemkeChristoph, ConcaAndreas, EngelmannJan, GerlachManfred, Havemann-ReineckeUrsula, HefnerGudrun, FlorioVincenzo, KuzinMaxim, LiebKlaus, ReisMargareta, RiemerThomas G, SerrettiAlessandro, SchoretsanitisGeorgios, ZernigGerald, GründerGerhard, HartXenia M

Improved clinical effects
None mentioned

There is a lack of systematic research on the relationship between escitalopram dose, blood levels, clinical effects, and serotonin transporter occupancy, necessitating further investigation to optimize escitalopram treatment.

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

24.

Gastrointestinal side effects associated with antidepressant treatments in patients with major depressive disorder: A systematic review and meta-analysis.

Author: OlivaVincenzo, LippiMatteo, PaciRiccardo, Del FabroLorenzo, DelvecchioGiuseppe, BrambillaPaolo, De RonchiDiana, FanelliGiuseppe, SerrettiAlessandro

Antidepressant efficacy
Gastrointestinal side effects

This meta-analysis evaluated short-term rates of gastrointestinal side effects (SEs) in major depressive disorder (MDD) patients treated with second-generation antidepressants. Escitalopram and sertraline showed the highest rates of SEs, while mirtazapine had fewer gastrointestinal side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

25.

Comparative efficacy of placebos in short-term antidepressant trials for major depression: a secondary meta-analysis of placebo-controlled trials.

Author: HolperLisa, HengartnerMichael P

Unblinding bias

The study explores the unblinding bias in antidepressant trials due to drug side effects, and how this can lead to placebo ratings being less effective for the drug in question compared to other antidepressants.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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