Escitalopram: uses, side effects and cautions

The NHS lists five conditions. Depression and OCD are two; the other three are generalised anxiety disorder, social anxiety disorder and panic disorder. This breadth means a prescriber may choose it when a person has depression alongside anxiety.

It is an SSRI, so it increases serotonin levels in the brain.

Escitalopram comes as ordinary tablets, as orodispersible tablets and as liquid drops. Tablets are swallowed whole. Orodispersible tablets dissolve on the tongue, which can help if swallowing pills is difficult. Drops are an alternative for those who prefer a liquid.

It is usually taken once a day. Eating or not eating makes no difference.

The NHS says it can take several weeks until your symptoms start to improve. For depression, plan on taking it for six months or more, because stopping early can allow symptoms to return.

If you miss a dose, take it as soon as you remember unless the next dose is soon, and never take two together. The NHS describes an extra dose as dangerous and says to call NHS 111 if that happens.

Most side effects ease within a couple of weeks. The NHS says some can last longer; tell a pharmacist or doctor if they trouble you.

• Common: headaches, nausea or vomiting, sweating, diarrhoea or constipation, joint or muscle pain, dizziness, sleepiness, anxiety, restlessness, weight or appetite changes, sleep problems and reduced sex drive.

• Serious, via NHS 111: anaphylaxis, serotonin syndrome, an irregular heartbeat called torsades de pointes (sometimes with fainting), internal bleeding, or thoughts of suicide or self-harm.

• If told to go to A&E, call an ambulance rather than driving yourself.

Heart rhythm problems, bleeding disorders, kidney or liver issues, diabetes, epilepsy, heart disease, glaucoma and previous mania are all on the NHS list of points to raise before starting. A past serious reaction to an antidepressant matters too.

The NHS names MAOIs, heart rhythm medicines, warfarin, aspirin and ibuprofen, antihistamines, ulcer medicines and St John's wort as medicines or supplements that can clash with it.

The NHS says escitalopram can be used in pregnancy if needed at the lowest effective dose, with a hospital birth recommended. It is sometimes used while breastfeeding, but you should discuss that with your doctor first.

Alcohol increases side effects such as drowsiness, so the NHS says it is best not to drink.

Do not stop suddenly. The dose is reduced gradually over several weeks or months so the body can adjust. Suspected side effects can be reported through the MHRA Yellow Card scheme.