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What is Escitalopram and what are its indications: Escitalopram belongs to a group of antidepressants called selective serotonin reuptake inhibitors (SSRIs). These drugs work on the serotonin system in the brain by increasing the level of serotonin. Disorders in the serotonin system are considered an important factor in the development of depression and related illnesses. Escitalopram is used to treat depression (major depressive episodes) and anxiety disorders (such as panic disorder with or without agoraphobia, social anxiety disorder, generalized anxiety disorder, obsessive-compulsive disorder). It may take two weeks before you start feeling improvement. Continue taking Escitalopram, even if it takes some time before you feel any improvement in your condition. You should talk to your doctor if you do not feel better or if you feel worse. What you need to know before using Escitalopram: Do not use Escitalopram: if you are allergic to Escitalopram or any of the other ingredients in this medicine if you were born or suffered from an abnormal heartbeat (shown in an electrocardiogram; a test to assess how the heart works). Precautions and warnings: You should inform your doctor of the following: if you have epilepsy. Treatment with Escitalopram should be stopped if seizures occur simultaneously or if there is an increase in seizure frequency if you have liver or kidney dysfunction. Your doctor may need to adjust your dose. if you have diabetes. Treatment with Escitalopram may alter blood sugar control. Dose adjustments of insulin and/or oral hypoglycemic agents may be necessary. if you have low sodium levels in the blood. if you are prone to bleeding or bruising easily. if you are receiving electroconvulsive therapy. if you have coronary heart disease. if you have or have had heart problems or recently had a heart attack. if you have a low resting heart rate and/or know you may be depleted of salt due to severe diarrhea and prolonged vomiting (illness) or use of diuretics (water pills). if you experience rapid heartbeat or irregular heartbeat, fainting, collapse, dizziness upon standing, which may indicate abnormal heart rate. if you have or have had eye problems, such as certain types of glaucoma (increased pressure in the eye). Other medicines and Escitalopram: inform your doctor about the medicines you are taking, especially tell your doctor if you are taking: "non-selective monoamine oxidase inhibitors (MAOIs)", which contain phenelzine, isocarboxazid, tranylcypromine as active ingredients. If you have taken any of these medicines, you will need to wait 14 days before starting Escitalopram. After stopping Escitalopram, you should wait 7 days before taking any of these medicines. "Reversible monoamine oxidase A inhibitors", which contain moclobemide (used to treat depression). "Irreversible monoamine oxidase B inhibitors", which contain selegiline (used to treat Parkinson’s disease). These increase the risk of side effects. The antibiotic linezolid. Lithium (used to treat bipolar disorder) and tryptophan. • Imipramine and desipramine (both used to treat depression). Sumatriptan and similar drugs (used to treat migraines) and tramadol (used for severe pain). These increase the risk of side effects. Cimetidine, lansoprazole, omeprazole (used to treat stomach ulcers), fluconazole (used to treat fungal infections), fluvoxamine (antidepressant), ticlopidine (used to reduce stroke risk). These may cause increased blood levels of Escitalopram. St. John’s Wort (Hypericum perforatum) - herbal remedy used to treat depression. Acetylsalicylic acid and non-steroidal anti-inflammatory drugs (used to relieve pain or thin the blood, called anticoagulants) may increase bleeding tendency. Warfarin, dipyridamole, and phenprocoumon (used to thin the blood, also called anticoagulants). Your doctor may check your blood clotting time when starting and stopping Escitalopram to ensure your anticoagulant dose remains adequate. Mefloquine (used to treat malaria), bupropion (used to treat depression), and tramadol (used for severe pain) due to the potential risk of minimal seizures. Antipsychotics (used to treat schizophrenia and psychosis) and antidepressants (tricyclic antidepressants and SSRIs) due to the potential risk of minimal seizures. Flecainide, propafenone, and metoprolol (used in cardiovascular diseases), clomipramine and nortriptyline (antidepressants), risperidone, thioridazine, and haloperidol (antipsychotics). Dose adjustment of Escitalopram may be needed. Medicines that reduce potassium or magnesium levels in the blood, as these conditions increase the risk of life-threatening arrhythmia. Children and adolescents should not usually use Escitalopram under 18 years of age. How to use Escitalopram: Always take Escitalopram exactly as your doctor has told you. Consult your doctor or pharmacist if you are not sure. The recommended usual dose of Escitalopram is 10 mg taken once daily. Your doctor may increase the dose to a maximum of 20 mg per day. Panic disorder: The starting dose of Escitalopram is 5 mg once daily for the first week before increasing to 10 mg per day. Your doctor may increase the dose to a maximum of 20 mg per day. Social anxiety disorder: The usual recommended dose of Escitalopram is 10 mg