Adverse reactions are most frequent during the 1st or 2nd week of treatment and usually decrease in intensity and frequency with continued treatment.
After prolonged administration, abrupt cessation of SSRIs may produce withdrawal reactions in some patients. Although withdrawal reactions may occur on stopping therapy, the available preclinical and clinical evidence does not suggest that SSRIs cause dependence.
Withdrawal symptoms (dizziness, headache and nausea) have been observed in some patients after abrupt discontinuation of escitalopram treatment.
Most symptoms were mild and self-limiting. In order to avoid withdrawal reactions, tapered discontinuation over 1-2 weeks is recommended.
The following adverse reactions have occurred more frequently with escitalopram than with placebo in double-blind placebo-controlled studies. The frequencies listed are not placebo-corrected (uncommon: >1/1000, <1/100; common >1/100, <1/10; very common >1/10).
Metabolism and Nutrition Disorders:
Common: Decreased appetite.
Common: Decreased libido, anorgasmia (female).
Nervous System Disorders:
Common: Insomnia, somnolence, dizziness. Uncommon: Taste disturbance, sleep disorder.
Respiratory, Thoracic and Mediastinal Disorders:
Common: Sinusitis, yawning.
Very common: Nausea. Common: Diarrhea, constipation.
Skin and Subcutaneous Tissue Disorders:
Common: Increased sweating.
Reproductive System and Breast Disorders:
Common: Ejaculation disorder, impotence.
General Disorders and Administration Site Conditions:
Common: Fatigue, pyrexia.
The following adverse reactions apply to the therapeutic class of SSRIs.
Disorders of Metabolism and Nutrition:
Hyponatremia, inappropriate ADH secretion.
Disorders of the Eye:
Nausea, vomiting, dry mouth, diarrhea, anorexia.
Insomnia, dizziness, fatigue, drowsiness, anaphylactic reactions.
Abnormal liver function tests.
Seizures, tremor, movement disorders, serotonin syndrome.
Hallucinations, mania, confusion, agitation, anxiety, depersonalization, panic attacks, nervousness.
Renal and Urinary Disorders:
Galactorrhea, sexual dysfunction terms including impotence, ejaculation disorder, anorgasmia.
Rash, ecchymoses, pruritus, angioedema, sweating.