Escitalopram is used for:

Treating depression and anxiety. It may also be used for other conditions as determined by your doctor.

Escitalopram is a selective serotonin reuptake inhibitor (SSRI) type of antidepressant. It works by increasing the activity of a chemical in the brain called serotonin, which helps to elevate mood.

Do NOT use Escitalopram if:

• you are allergic to any ingredient in Escitalopram or to citalopram
• you are taking or have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) in the last 14 days
• you are taking citalopram, linezolid, pimozide, selegiline, tramadol, or any weight loss medicines (eg, phentermine)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Escitalopram :

Some medical conditions may interact with Escitalopram. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any other prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have or have a history of a bipolar condition (mania or manic-depression) or suicidal thoughts or behaviors
• if you have or have a history of kidney or liver problems, a heart attack, seizures (convulsions), or stomach or intestinal bleeding

Some MEDICINES MAY INTERACT with Escitalopram. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Citalopram should not be taken with Escitalopram because they have the same chemical formula
• MAO inhibitors (eg, phenelzine), linezolid, or selegiline because they can cause serious, sometimes fatal, reactions, including restlessness, fever, excessive sweating, confusion, twitching, and seizures. Do NOT takeMAO inhibitors (eg, phenelzine), linezolid, or selegiline within 2 weeks of taking Escitalopram.
• Lithium, St. John's wort, tramadol, sumatriptan, orweight loss medicines (eg, phentermine because side effects such as restlessness, fever, excessive sweating, confusion, twitching, and seizures which can rarely be life-threatening, may occur
• Beta-blockers (eg, propranolol, metoprolol) because side effects such as very slow heart rate may be increased by Escitalopram
• Nonsteroidal anti-inflammatory agents (NSAIDs; eg, ibuprofen, celecoxib), oral anticoagulants (eg, warfarin), or salicylates (eg, aspirin) because the risk of stomach bleeding may be increased by Escitalopram
• Pimozide because side effects such as racing heartbeat, dizziness, fainting, life-threatening irregular heartbeat leading to unconsciousness and lack of heartbeat may increase by Escitalopram

This may not be a complete list of all interactions that may occur. Ask your health care provider if Escitalopram may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Escitalopram :

Use Escitalopram as directed by your doctor. Check the label on the medicine for exact dosing instructions. Check the label on the medicine for exact dosing instructions.

• Escitalopram comes with an additional patient information sheet called a Medication Guide. Read it carefully and reread it each time you get Escitalopram refilled.
• Escitalopram may be taken with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
• Several weeks may pass before Escitalopram reaches full effect. Continue to use Escitalopram even if you feel well. Do not miss any doses.
• If you miss a dose of Escitalopram , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Escitalopram.

Important safety information:

• Escitalopram may cause drowsiness, dizziness, and lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Escitalopram. Using Escitalopram alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Avoid drinking alcohol or taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while taking Escitalopram. Escitalopram will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Antidepressants can increase suicidal thoughts and actions in some children and teenagers. This risk may be higher in individuals with bipolar illness (also called manic-depressive illness), a family history of bipolar illness, or a history of attempting suicide. Pay close attention to changes in moods or actions, especially if changes occur suddenly. Contact your doctor right away if any of the following effects occur or worsen: depression, anxiety, restlessness or irritability, panic attacks, thoughts or attempts of suicide, or other unusual changes in behavior or mood.
• Use Escitalopram with caution in the ELDERLY because they may be more sensitive to its effects.
• Escitalopram is not recommended for use in CHILDREN. Safety and effectiveness have not been confirmed.
• PREGNANCY and BREAST-FEEDING: If you become pregnant, discuss with your doctor the benefits and risks of using Escitalopram , especially during the third trimester. Escitalopram is excreted in breast milk. If you are or will be breast-feeding while you are using Escitalopram , check with your doctor or pharmacist to discuss the risks to your baby.

Do NOT suddenly stop taking Escitalopram without your doctor's approval. Stopping Escitalopram suddenly may cause serious WITHDRAWAL symptoms, including abnormal skin sensations, agitation, anxiety, a state of feeling unwell or unhappy, confusion, dizziness, headache, inability to sleep, irritability, lethargy, nausea, sudden emotional swings, and sweating. If therapy with Escitalopram is to be stopped, your doctor will gradually decrease your dose.

Possible side effects of Escitalopram :

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Back pain; constipation; decreased sex drive; diarrhea; delay in ejaculation; dizziness; drowsiness; dry mouth; impotence; increased sweating; lack of orgasms; loss of appetite; nausea; trouble sleeping; unusual fatigue; upset stomach; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); agitation; anxiety; black or tarry stools; changes in amount of urine; chest pain; hostility; impulsiveness; irritability; mania; muscle cramps; painful or prolonged erection; panic attacks; restlessness; seizures; sleeplessness; stomach pain; suicidal thoughts; thoughts of hurting yourself; uncontrolled movements (tremors); unusual bleeding or bruising; unusual or severe mental/mood changes; unusually fast or slow heartbeat; vision changes; vomit that looks like coffee grounds; worsening of depression.

What is the shelf life of the pills?

• The expiry date is mentioned on each blister. It is different for different batches. The shelf life is 2 years from the date of manufacture and would differ from batch to batch depending on when they were manufactured.

Other Useful Information:

Radiation: 1. Rays of energy. Gamma rays and X-rays are two of the types of energy waves often used in medicine. 2. The use of energy waves to diagnose or treat disease.

Replantation: 1. Literally, the act of planting again. 2. In surgery, the restoration of any part of the body to its original site. Also known as reimplantation.

The Chinese surgeon Zhong Wei Chen (1929-2004) was the "father of replantation." Dr. Chen was the first to reattach a severed hand with success which he did in 1963. Dr. Chen also developed many microsurgical procedures including techniques for preserving severed extremities, reattaching amputated fingers and thumbs, reconstructing muscles and repairing nerves and blood vessels.

Rheumatism: Rheumatism is an older term, used to describe any of a number of painful conditions of muscles, tendons, joints, and bones.

Rheumatism conditions have been classified as either localized, regional, or generalized. Localized rheumatism conditions include bursitis and tendinitis. Regional rheumatism conditions include chest wall pain, temporomandibular joint pain, and myofascial pain syndromes. Generalized rheumatism conditions include fibromyalgia.

Another category of rheumatism is psychogenic rheumatism. With this term it is understood that the patient is reporting inconsistent pains of muscles and joints that do not correspond to true anatomy and physiology. The patient is felt to have underlying psychological causes for the symptoms.

Rheumatology: A subspecialty of internal medicine that involves the non-surgical evaluation and treatment of the rheumatic diseases and conditions. Rheumatic diseases and conditions are characterized by symptoms involving the musculoskeletal system. Many of the rheumatic diseases and conditions feature immune system abnormalities. Therefore, rheumatology also involves the study of the immune system. Classical rheumatology training includes 4 years of medical school, 1 year of internship in internal medicine, 2 years of internal medicine residency, and 2 years of rheumatology fellowship. There is a subspecialty board for rheumatology certification. The American College of Rheumatology is the official organization acting on behalf of the field of rheumatology in the United States.

T cell: A type of white blood cell that is of key importance to the immune system and is at the core of adaptive immunity, the system that tailors the body's immune response to specific pathogens. The T cells are like soldiers who search out and destroy the targeted invaders.

Immature T cells (termed T-stem cells) migrate to the thymus gland in the neck, where they mature and differentiate into various types of mature T cells and become active in the immune system in response to a hormone called thymosin and other factors. T-cells that are potentially activated against the body's own tissues are normally killed or changed ("down-regulated") during this maturational process.

There are several different types of mature T cells. Not all of their functions are known. T cells can produce substances called cytokines such as the interleukins which further stimulate the immune response. T-cell activation is measured as a way to assess the health of patients with HIV/AIDS and less frequently in other disorders.

T cell are also known as T lymphocytes. The "T" stands for "thymus" -- the organ in which these cells mature. As opposed to B cells which mature in the bone marrow.

Teleology: The study of the ultimate purpose of the design of something in nature.

For example, "what is the true purpose of the nose?" is a teleological question and, to say that all evolutionary changes occur for a definite purpose is a teleological explanation of evolution.

"Teleology" comes from ancient Greek roots but it (and teleological) did not enter English until the 18th century. It is a compound of the Greek "tele-, telos," meaning "end or purpose" + the ending "logos" meaning "the science or study of" = the study of the ends or purposes.

Testosterone: A "male hormone" -- a sex hormone produced by the testes that encourages the development of male sexual characteristics, stimulates the activity of the male secondary sex characteristics, and prevents changes in them following castration. Chemically, testosterone is 17-beta-hydroxy-4-androstene-3-one.

Testosterone is the most potent of the naturally occurring androgens. The androgens cause the development of male sex characteristics, such as a deep voice and a beard; they also strengthen muscle tone and bone mass.

High levels of testosterone appear to promote good health in men, for example, lowering the risks of high blood pressure and heart attack. High testosterone levels also correlate with risky behavior, however, including increased aggressiveness and smoking, which may cancel out these health benefits.

Testosterone may be given to treat medical conditions, including female (but not male) breast cancer, hypogonadism (low gonadal function) in the male, cryptorchism (nondescent of the testis into the scrotum), and menorrhagia (irregular periods).