Escitalopram was developed in a close cooperation between Lundbeck and Forest Laboratories.

Its development was

initiated in the summer of 1997, and the resulting new drug application was submitted to the FDA in March 2001. The
short time (3.5 years) it took to develop escitalopram can be attributed to the previous extensive experience of
Lundbeck and Forest with citalopram, which has similar pharmacology.[3] The FDA issued the approval of
escitalopram for major depression in August 2002 and for generalized anxiety disorder in December 2003.
Escitalopram can be considered an example of "lifecycle management"[4] - the strategy pharmaceutical companies
use in order to extend the lifetime of a drug, in this case of the citalopram franchise. Escitalopram is an enantiomer of
citalopram, used for the same indication, and for that reason it required less investment and less time to develop.
Two years after escitalopram's launch, when the patent on citalopram expired, the escitalopram sales successfully
made up for the loss. On May 23 2006, the FDA approved a generic version of escitalopram by Teva.[5] However, on
July 14 of that year, the U.S. District Court of Delaware decided in favor of Lundbeck regarding the patent
infringement dispute and ruled the patent on escitalopram valid.[6]

Despite the drug's similarity, preclinical as well as various clinical studies (including double-blinded studies—
considered the gold standard of clinical evidence) have shown differentiated effects of citalopram and escitalopram,
[7]
 as well as a clinical superiority compared to a variety of other SSRIs, such as paroxetine,[8] especially in severely
depressed patients and sertraline. Compared to newer serotonin-norepinephrine reuptake inhibitors such
as venlafaxine[9] and duloxetine[10] escitalopram was shown to be at least as effective.

Nursing Considerations

Assessment

History: Allergy to any antihistamines; narrow-angle glaucoma, stenosing peptic ulcer,

symptomatic prostatic hypertrophy, asthmatic attack, bladder neck
obstruction, pyloroduodenal obstruction, pregnancy, lactation

Physical: Skin color, lesions, texture; orientation, reflexes, affect; vision examination; P, BP; R,
adventitious sounds; bowel sounds; prostate palpation; CBC with differential.count.

Take as prescribed; avoid excessive dosage. Take with food if GI upset occurs.

Avoid alcohol; serious sedation may occur.

You may experience these side effects: Dizziness, sedation, drowsiness (use caution driving or
performing tasks that require alertness); epigastric distress, diarrhea, or constipation (take with meals;
consult care provider if severe); dry mouth (frequent mouth care; sucking on sugarless lozenges may
help); thickening of bronchial secretions, dryness of nasal mucosa (use a humidifier).