| Anxiety disorders or short-term relief of anxiety symptoms (label). View labelExact | Start 7.5 mg twice daily (or 5 mg three times daily); increase by ~5 mg/day every 2–3 days as tolerated. | Non-benzodiazepine anxiolytic; 5-HT1A partial agonist (azapirone). | CYP3A4 | Single-dose range 2–3 h | No | — | - Follow-up within 2–4 weeks is commonly used to assess adherence, side effects, and whether anxiety symptoms are trending in the right direction.
- Dizziness and activation are commonly tracked during titration; slower titration can help if patients feel “wired” or unsteady.
- Interacting medications (CYP3A4 inhibitors/inducers) and food consistency (grapefruit) are worth reviewing when response changes.
- If no meaningful benefit after an adequate trial, stopping and switching or augmenting is common rather than continuing indefinitely.
| No | 2025-12-28 |
|---|
| MDD; OCD; panic disorder; PTSD; social anxiety disorder. View labelExact | Start 50 mg once daily for major depressive disorder (clinical depression) or anxiety; titrate by 25–50 mg increments every ≥1 week to 100–200 mg/day (max 200 mg/day). | Selective serotonin reuptake inhibitor (SSRI). | Multiple CYPs | Steady-state mean 26 h | No | — | - Suicidality and psychiatric activation during initiation and dose changes, especially in younger patients and in bipolar-spectrum illness.
- Sodium in older adults or patients on diuretics if symptoms suggest hyponatremia (confusion, fatigue, falls).
- Bleeding/bruising risk when combined with NSAIDs, antiplatelets, or anticoagulants; reinforce early symptom reporting.
- Medication reconciliation when TCAs, antipsychotics, or other serotonergic agents are co-prescribed; anticipate switching washout needs when regimens change.
| No | 2025-12-28 |
|---|
| Major depressive disorder; generalized anxiety disorder. View labelExact | Typical adult start is 10 mg once daily; may increase to 20 mg/day after ≥1 week if needed and tolerated. | Selective serotonin reuptake inhibitor (SSRI). | CYP2C19, CYP2D6 (minor), CYP3A4 (minor) | Single-dose mean 27 h; Single-dose range 27–32 h; Steady-state mean 30 h | No | — | - Suicidality and psychiatric activation (anxiety, agitation, mood elevation) during initiation and dose changes, especially in younger patients.
- Sodium in older adults or patients on diuretics if symptoms suggest hyponatremia.
- Bleeding/bruising risk when combined with NSAIDs, antiplatelets, or anticoagulants; reinforce early symptom reporting.
- Medication reconciliation to avoid serotonergic combinations and to anticipate washout needs during antidepressant switching.
- ECG when cardiac risk is present or when combining multiple QT-active medications, even though escitalopram’s QT effect is typically smaller than citalopram.
| No | 2026-02-12 |
|---|
| Seizure disorders; panic disorder. View labelExact | Panic disorder (label): start 0.25 mg twice daily; increase every 3 days to 1 mg twice daily; maximum 4 mg/day. | Benzodiazepine; enhances GABA‑A receptor activity. | Hepatic | Steady-state mean 35 h | No | | - Sedation, cognition, gait/ataxia, and fall risk at each visit; counseling commonly covers driving and occupational safety after dose changes.
- Respiratory risk (sleep apnea, COPD) and co-prescribed CNS depressants; overdose education is important, and some settings coordinate naloxone when opioids are unavoidable.
- Misuse/diversion risk: PDMP review, documentation of indication/duration, and periodic reassessment with a time-limited plan are common.
- Withdrawal risk: written taper schedules, tracking rebound anxiety/insomnia, and slower tapers for long-term users or higher doses are typical.
| No | 2026-02-20 |
|---|