Cipralex

Cipralex is the brand name used for escitalopram, a selective serotonin reuptake inhibitor (SSRI) developed for the treatment of mood and anxiety disorders. Escitalopram is the S-enantiomer of citalopram and is marketed under various brand names in different countries; in the United States the corresponding product is sold as Lexapro.

Indications and mechanism. Cipralex is indicated for major depressive disorder and generalized anxiety disorder in many jurisdictions, with approval for other anxiety disorders varying by country. The drug works by preferentially inhibiting the reuptake of serotonin (5-HT) into presynaptic neurons, increasing serotonin availability in brain circuits involved in mood and anxiety. It is typically taken once daily, with dosing adjusted for age, hepatic function, and comorbidities. After starting treatment, improvement in mood and anxiety symptoms may take several weeks.

Pharmacokinetics and dosing. Cipralex is administered orally and has high oral bioavailability with a half-life generally around 27 to 32 hours, leading to steady-state levels within one to two weeks. It is mainly metabolized in the liver and eliminated through the kidneys. Typical starting doses are around 10 mg once daily, with a customary maximum of 20 mg daily; dose adjustments are advised for hepatic impairment and the elderly.

Safety and interactions. Common adverse effects include nausea, sleep disturbance, fatigue, sexual dysfunction, dry mouth, and increased sweating. Serious risks, though uncommon, include suicidality in young people, hyponatremia, serotonin syndrome when combined with other serotonergic agents, and QT prolongation at high doses. Discontinuation symptoms may occur with abrupt stopping; gradual tapering is recommended. Cipralex should not be used with monoamine oxidase inhibitors or other strong contraindicated medications, and a washout period is recommended when switching therapies. Pregnancy and breastfeeding considerations require medical evaluation, weighing potential risks and benefits.