中文依地普仑（Lexapro）介绍
商品名:Lexapro
通用名: 草酸依他普仑片
英文名:Escitalopram Tablets (es-sye-TAL-oh-pram)
化学名：(S)-1-[3-(二甲胺基)丙基]-1-(4-氟苯基)-1,3-二氢-5-异苯并呋喃腈
草酸依地普仑Escitalopram 是一种新型的选择性5一羟色胺再摄取抑制剂（SSRIs)。选择性5一羟色胺再摄取抑制剂已取代了三环类抗抑郁药物成为抑郁治疗的一线用药，其原因在于它们不仅具有三环类抗抑郁药相似的疗效，同时具有相对较好的耐受性以及过量时较好的安全性。
         
草酸依地普仑是单纯的SSRIs，其对5一羟色胺再摄制抑制的相对选择性在同类药物中最高，抗抑郁作用优于西酞普兰，起效快．服用剂量小，耐受性好，副反应小，药物相互作用少等优点，可以与其他药物联合应用。与其他SSRIs一样，成为抗重性抑郁的第一线用药。最常见的副反应是恶心、失眠、射精障碍、腹泻、口干、思睡，只有恶心发生率>10％ 。

安全性与耐受性：
         
Wade(2002)报道：草酸依地普仑的副作用通常很少，很轻，且短暂。最常见的副反应有：恶心、多汗、口干、头痛和睡眠时间缩短。通常在治疗开始的第1或第2周时较明显，随着抑郁状态的改善一般都逐渐消失。在稀有个案中曾观察到癫痫发作。在已患有心动过缓的患者中，心动过缓可使治疗更复杂。
          
与三环类抗抑郁药相比，草酸依地普仑很少引起过度镇静、嗜睡、体质量增加、和直立性低血压、性功能障碍等副反应。尤其无体质量增加及性功能障碍使得依地普仑远比三环类抗抑郁药易于为患者接受。
          
草酸依地普仑在人怀孕期的安全性尚未确定，动物实验未显示任何致畸形可能的证据。并且，不影响生殖或产期状态。不影响心脏传导系统及血压，这一点对老年患者尤为重要。也不影响血液，肝肾等系统。

药物过量时，达6OO mg出现疲乏、无力、嗜睡、头晕、手颤、恶心。最高服用剂量记录约为2 000mg，患者在木僵及呼吸困难状态下入院，但没有心脏中毒的迹象，患者很快康复。
 
禁用于已在使用单胺氧化酶抑制剂治疗者，单胺氧化酶抑制剂至少停用14 d后方可使用本品。禁用于对本药品制剂成份有过敏史者。
与单胺氧化酶抑制剂合用时会出现致命的5一羟色胺综合征，因此两药使用间隔应在14 d以上。

用法与用量
成人：草酸依地普伦每日服用一次。开始10 mg／d，如临床适应剂量可增加至20 mg／d，或有需要时增加至30 mg／d。超过65岁的患者，剂量减半，即5—15 mg／d。
抗抑郁剂治疗属于对症治疗，必须持续相当长的时间，一般说来对双相障碍性一抑郁障碍需要治疗4—6个月。若出现失眠或严重的静坐不能，在急性期建议辅助镇静剂治疗.

Forest公司日前公布，Lexapro(escitalopram oxalate，草酸依地普仑)治疗儿童和成人抑郁症的2项最新临床研究结果。
         
2项临床研究显示，依地普仑在儿童和成人患者中耐受性良好，与安慰剂组相比，停药率无显著差异。安慰剂组报道2例自杀事件，1例病情恶化；而依地普仑组仅出现1例自杀事件，无病情恶化病例。依地普仑是西酞普兰的右旋体，此次临床研究及西酞普兰（citalopram）的临床研究显示，2种药物均未增加儿童自杀或患者病情恶化的风险。

一项多中心随机双盲临床研究纳入246例6～17岁大抑郁障碍患儿，纳入患儿的CDRS-R分值均大于等于40，患者接受依地普仑(10 mg/天～20
mg/天)或安慰剂，治疗为期8周，主要观测指标为CDRS-R（儿童抑郁量表修订版）分值的变化。次级评估指标为CGI-I（临床总体印象量表中总体改善项目）分值、CGI-S（临床总体印象量表中严重程度项目）分值和CGAS（儿童总评估量表）分值。临床研究初期已显示出，依地普仑组较安慰剂组在CGAS分和CGI-S分方面的改善优于安慰剂组，但并无统计学意义，治疗8周后，上述改善已显著优于安慰剂组。但在主要评价指标CDRS-R分值方面，依地普仑组与安慰剂组无显著差异。
         
依地普仑是最新型的SSRI（选择性5羟色胺再摄取抑制剂），于2002年8月获FDA批准，用于治疗大抑郁障碍和广泛性焦虑障碍，在美国的处方量已达500万张。
         
依地普仑常见不良反应有恶心、失眠、射精障碍、嗜睡、出汗增加、疲劳、性欲降低和性快感缺失。接受MAOIs（单胺氧化酶抑制剂）治疗者或对依地普仑过敏的患者不宜使用本品。作为SSRI，依地普仑不宜与TCAs（三环类抗抑郁剂）联用。依地普仑与非甾体抗炎药联用有可能增加出血风险。

商品名:Lexapro
通用名: 草酸依他普仑片
英文名:Escitalopram Tablets (es-sye-TAL-oh-pram)

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide.

Talk with the patient's doctor to be sure that the benefits of using Lexapro outweigh the risks.

Family and caregivers must closely watch patients who take Lexapro . It is important to keep in close contact with the patient's doctor.

Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor.
 
Lexapro适应证:用于治疗抑郁症或焦虑症.
Treating depression or generalized anxiety disorder. It may also be used for other conditions as determined by your doctor.

Lexapro is a 选择性5羟色胺再吸收抑制剂(SSRI).

It works by restoring the balance of serotonin, a natural substance in the brain, which helps to improve certain mood problems.

Lexapro禁忌证:
you are allergic to any ingredient in Lexapro
you are taking citalopram
you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg,phenelzine), selegiline, or St. John's wort within the last 14 days you are taking a fenfluramine derivative (eg, dexfenfluramine), an H1 antagonist (eg, astemizole, terfenadine), nefazodone, pimozide, or sibutramine Contact your doctor or health care provider right away if any of these apply to you.

使用前 :
Some medical conditions may interact with Lexapro .

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 prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse if you have a history of seizures, liver problems, severe kidney problems, stomach or bowel bleeding, or metabolism problems if you are dehydrated, have low blood sodium levels, or drink alcohol if you will be having electroconvulsive therapy (ECT) Some MEDICINES MAY INTERACT with Lexapro .

Tell your health care provider if you are taking any other medicines, especially any of the following:

Fenfluramine derivatives (eg, dexfenfluramine), linezolid, lithium, MAOIs (eg, phenelzine), metoclopramide, nefazodone, selegiline, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, St. John's wort, or trazodone because severe side effects, such as a reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma, may occur Anticoagulants (eg, warfarin), aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen) because the risk of bleeding, including stomach bleeding, may be increased Diuretics (eg, furosemide,hydrochlorothiazide) because the risk of low blood sodium levels may be increased Tramadol because the risk of seizures may be increased H1 antagonists (eg, astemizole, terfenadine) or phenothiazines(eg,chlorpromazine, thioridazine) because severe heart problems, including irregular heartbeat, mayoccurCarbamazepineorcyproheptadine because they may decrease Lexapro 's effectiveness Clozapine, pimozide, risperidone, or tricyclic antidepressants (eg, amitriptyline) because the risk of their side effects may be increased by Lexapro This may not be a complete list of all interactions that may occur. Ask your health care provider if Lexapro 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.

Lexapro 使用方法:
Use this medicine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Lexapro comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Lexapro refilled.
Take Lexapro by mouth with or without food.
Taking Lexapro at the same time each day will help you remember to take it.
Continue to take Lexapro even if you feel well. Do not miss any doses.
Do not suddenly stop taking Lexapro without checking with your doctor. Side effects may occur. They may include mental or mood changes, numbness or tingling of the skin, dizziness, confusion, headache, trouble sleeping, or unusual tiredness. You will be closely monitored when you start Lexapro and whenever a change in dose is made.
If you miss a dose of Lexapro , 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 dosingschedule. Do not take 2 doses at once.
Ask your health care provider any questions you may have about how to use Lexapro .

Important safety information:
Lexapro may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Lexapro with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
Do not drink alcohol while you are using Lexapro .
Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Lexapro ; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
One to 4 weeks may pass before your symptoms improve. Do NOT take more than the recommended dose, change your dose, or useLexaproforlongerthanprescribed without checking with your doctor.
Children, teenagers, and young adults who take Lexapro may be at increased risk for suicidal thoughts or actions. Watch all patients who take Lexapro closely. Contact the doctor at once if new, worsened, or sudden symptoms such as depressed mood; anxious, restless, or irritable behavior; panic attacks; or any unusual change in mood or behavior occur. Contact the doctor right away if any signs of suicidal thoughts or actions occur.
Lexapro and a medicine called citalopram have the same active ingredient. Do not take Lexapro if you are also taking citalopram.
If your doctor tells you to stop taking Lexapro , you will need to wait for several weeks before beginning to take certain other medicines (eg, MAOIs, nefazodone). Ask your doctor when you should start to take your new medicines after you have stopped taking Lexapro .
Lexapro may rarely cause a prolonged, painful erection. This could happen even when you are not having sex. If this is not treated right away, it could lead to permanent sexual problems such as impotence. Contact your doctor right away if this happens.
Serotonin syndrome is a possibly fatal syndrome that can be caused by Lexapro . Your risk may be greater if you take Lexapro with certain other medicines (eg, "triptans," MAOIs). Symptoms may include agitation; confusion; hallucinations; coma; fever; fast or irregular heartbeat; tremor; excessive sweating; and nausea, vomiting, or diarrhea. Contact your doctor at once if youhaveanyofthesesymptoms.
Caution is advised when using Lexapro in the ELDERLY; they may bemoresensitive to its effects, especially low blood sodium levels.
Caution is advised when using Lexapro in CHILDREN; they may be more sensitive to its effects, especially increased risk of suicidal thoughts or actions.
Lexapro should be used with extreme caution in CHILDREN;safetyandeffectiveness in children have not been confirmed.
Lexapro may cause weight changes. CHILDREN and teenagers may need regular weight and growth checks while they take Lexapro .
PREGNANCY and BREAST-FEEDING: Lexapro may cause harm to the fetus if it is used during the last 3 months of pregnancy. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Lexapro while you are pregnant. Lexapro is found in breast milk. Do not breast-feed while taking Lexapro .

Lexapro副作用 :
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:

Constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; headache; increased sweating; lightheadedness when you stand or sit up; loss of appetite; nausea; stomach upset; tiredness; trouble sleeping.

Seek medical attention right away if any of these SEVERE side effects occur:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bizarre behavior; black or bloody stools; chest pain; confusion; decreased concentration; fast or irregular heartbeat; hallucinations; memory loss; menstrual period changes; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, restlessness, or inability to sit still; persistent or severe ringing in the ears;persistent, painful erection; red, swollen, blistered, or peeling skin; seizures; severe or persistent anxiety or trouble sleeping; stomach pain; suicidal thoughts or attempts; tremor; unusual bruising or bleeding; unusual or severe mental or mood changes; vision changes; worsening of depression.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

服用过量:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include coma; fast, slow, or irregular heartbeat; seizures; severe or persistent dizziness, drowsiness, nausea, or vomiting.

Lexapro 最佳用量:
Store Lexapro at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Lexapro out of the reach of children and away from pets.