Escitalopram — Depression & Anxiety Medication | KiwiMeds
✅ Reviewed by a Registered Pharmacist NZ | Last updated: May 2026 | This information is for educational purposes only and does not replace advice from your doctor or pharmacist.
What is escitalopram?
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It is the refined version of citalopram and is considered one of the most well-tolerated antidepressants. Brand names in New Zealand include Lexapro and various generics.
What is it used for? (NZ context)
Escitalopram is prescribed for major depression, generalised anxiety disorder, social anxiety disorder, and panic disorder. It is one of the most commonly prescribed SSRIs in New Zealand due to its tolerability and effectiveness. Pharmac funds escitalopram.
How does it work?
Escitalopram blocks the reuptake of serotonin in the brain, increasing serotonin levels at synapses. Serotonin is a neurotransmitter involved in mood regulation. The therapeutic effect builds over 2–4 weeks as the brain adapts to the change in serotonin signalling.
How to take it
Escitalopram is taken once daily, with or without food. Start at a low dose (usually 5–10mg) and increase if needed. Antidepressants should be continued for at least 6–12 months after feeling well. Never stop suddenly — taper gradually under medical guidance to avoid discontinuation symptoms.
Common side effects
- Nausea — usually improves after 1–2 weeks
- Insomnia or drowsiness
- Headache
- Dry mouth
- Sweating
- Sexual side effects (delayed ejaculation, reduced libido)
Serious side effects to watch for
Like all antidepressants, monitor for increased suicidal thoughts especially in young adults under 25 when starting or changing dose. Serotonin syndrome (agitation, shaking, rapid heart rate) is rare but serious. Report any unusual bleeding as SSRIs can affect platelet function.
Important drug interactions
MAOIs — never combine; allow 14 days gap. Tramadol — increased serotonin syndrome risk. NSAIDs and aspirin — slightly increased bleeding risk (particularly gastrointestinal). Warfarin — monitor INR closely. QT-prolonging medicines — escitalopram can prolong the QT interval at higher doses.
NZ-specific information
Pharmac funding: Escitalopram 10mg and 20mg tablets are funded by Pharmac. Multiple generic brands are available at pharmacies across New Zealand.
Frequently asked questions
Is escitalopram better than other antidepressants?
Escitalopram consistently rates highly in comparative studies for tolerability (fewer side effects) and efficacy. It is often a first-choice SSRI. However, antidepressant choice is highly individual — what works best varies from person to person.
Will escitalopram change my personality?
Escitalopram treats depression and anxiety rather than changing personality. Most people feel more like themselves — less weighed down by depressive or anxious symptoms. Some people notice they feel more emotionally “flat” — if this bothers you, discuss it with your doctor.
What do I do if I miss a dose?
Take it as soon as you remember, unless it is nearly time for your next dose — then skip the missed dose. Do not double up. SSRIs have fewer discontinuation effects from a single missed dose than SNRIs like venlafaxine.
💬 Talk to your pharmacist or doctor for personalised advice about escitalopram.
Reviewed by a Registered Pharmacist NZ | BPharm, Pharmacy Council of New Zealand
References & Further Information
The following New Zealand and international resources were used to inform this page: