Key facts
- Type: Antidepressant · SSRI
- ATC Code: N06AB10
- Kenya EML 2023: Listed
- Level of Use: Level 4 to 6
This is health education, not medical advice. Never start, stop, or change a medication without speaking to a qualified healthcare professional first.
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Prescription Only Medicine
Available on prescription from a registered healthcare provider in Kenya.
What it treats
Which conditions is Escitalopram used for?
Depression · Generalised Anxiety Disorder · Panic Disorder · Social Anxiety Disorder · OCD
Overview
What is Escitalopram?
Escitalopram is a selective serotonin reuptake inhibitor (SSRI) antidepressant. It is a refined version of an earlier medicine called citalopram, developed to retain only the portion of the molecule responsible for the therapeutic effect.
Large-scale studies comparing antidepressants have consistently placed escitalopram near the top for the combination of effectiveness and tolerability, making it a frequent first choice for both depression and generalised anxiety disorder.
It is listed in Kenya’s Essential Medicines List 2023 and is available through both public and private healthcare facilities.
How it works
What does it do in the brain?
Escitalopram targets the serotonin transporter with high precision, blocking the removal of serotonin from the space between nerve cells. By allowing serotonin to remain active for longer, it gradually improves mood regulation and reduces anxiety. Its high selectivity means it has fewer off-target effects compared to older antidepressants.
Formulations in Kenya
How is it available?
Tablet 5 mg Taken by mouth Available at private pharmacies
Tablet 10 mg Taken by mouth Available
Tablet 20 mg Taken by mouth Available
Availability across Africa
Where is it available in Africa and what is it called?
Names and availability vary by country. Always confirm with a local pharmacist or healthcare provider.
| Country | Common Brand Name(s) | Notes |
|---|---|---|
| Kenya | Escital, Ectasule, generic | On KEML 2023. Available at public and private facilities. |
| South Africa | Cipralex, Lexamil, generic | Widely available on South Africa EML. |
| Nigeria | Nexito, generic | Available in urban private pharmacies and tertiary hospitals. |
| Ghana | Cipralex, generic | Available at teaching hospitals and specialist facilities. |
| Uganda | Generic escitalopram | Available at urban pharmacies and referral hospitals. |
| Tanzania | Generic escitalopram | Available at regional referral hospitals. |
| Ethiopia | Generic escitalopram | Available through private pharmacies in major cities. |
Side effects
What might you feel while taking it?
These are the most commonly reported effects. Not everyone experiences them, and many settle within the first few weeks.
- Nausea, which usually settles within the first week or two
- Headaches
- Difficulty sleeping or unusual drowsiness
- Dry mouth
- Sweating more than usual
- Changes in sexual desire or response
- Loose stools or changes in bowel habit
Go to a doctor or emergency room straight away if you notice any of the following.
- If you have a heart condition, tell your doctor before starting. Escitalopram can affect the heart’s electrical activity.
- Thoughts of harming yourself, especially in young people in the first few weeks
- Headache, difficulty concentrating, confusion, or weakness, particularly in elderly patients. These may be signs of low blood sodium.
Risks
Important risks you should understand before taking this medicine
Read this section carefully.
These are real risks associated with this medicine that every person taking it should be aware of.
- Escitalopram can cause a dose-dependent prolongation of the heart’s electrical cycle, called QT prolongation. People with heart disease, heart rhythm disorders, or electrolyte imbalances must tell their doctor before starting.
- Like all SSRIs, it can increase the risk of suicidal thinking in young people in the first few weeks. Close monitoring during this period is essential.
- Low sodium levels in the blood, a condition called hyponatraemia, can occur particularly in elderly patients. Symptoms include headache, confusion, and weakness. Contact your doctor if you notice these.
- Stopping escitalopram suddenly causes discontinuation syndrome, which includes dizziness, electric shock sensations, and mood changes. Always reduce gradually under medical supervision.
Who should not take it
Important warnings before starting
Tell your doctor about all your medical conditions, allergies, and other medicines before starting Escitalopram.
- You are currently taking a medicine from the MAOI class
- You have been told you have long QT syndrome or another significant heart rhythm disorder
- You are taking the antipsychotic medicine pimozide
Special care needed
Situations that need extra attention
- Tell your doctor if you have a heart condition, including any history of irregular heartbeat
- Elderly patients should start on a lower dose as advised by their doctor
- Tell your doctor about any history of manic episodes or bipolar disorder
- If you have liver disease, your doctor will use a lower dose
Pregnancy
Speak to your doctor before taking escitalopram during pregnancy. It should not be started or stopped without medical guidance.
Breastfeeding
Low levels pass into breast milk. Generally considered compatible with breastfeeding, but your doctor will assess your individual situation.
Other medicines
Medicines and substances that can interact with it
Always tell your doctor and pharmacist about every medicine, supplement, and herbal remedy you take, including those bought without a prescription.
- MAOIs: Dangerous combination that must be avoided. Your doctor will guide you on the required gap between these medicines.
- Medicines that affect heart rhythm: Escitalopram can mildly affect the heart’s electrical cycle. Any medicine that also does this needs to be reviewed.
- Blood thinners such as warfarin: Increased risk of bleeding. Monitoring is needed.
- Alcohol: Amplifies side effects, particularly dizziness and fatigue.
Tests and follow-up
What your doctor will monitor
- A follow-up appointment within the first two to four weeks
- Patients with cardiac risk factors may have an ECG before starting
- Elderly patients may have blood salt levels checked periodically
- Diabetic patients will have blood sugar monitored as it may be affected
Stopping this medicine
What happens if you stop taking it?
Do not stop escitalopram suddenly. Stopping without gradually reducing the dose can cause dizziness, nausea, and a sensation sometimes described as brain zaps. Your doctor will guide you through a slow reduction.
In Kenya
What you should know about this medicine in Kenya
Escitalopram is available in Kenya and increasingly affordable as generic versions enter the market. It is stocked in many county hospitals and private pharmacies.
Its once-daily dosing makes it straightforward to take regularly. Consistent daily use over weeks is what produces results.
For those managing both depression and significant anxiety together, escitalopram’s documented efficacy across both conditions makes it a practical clinical choice.
Sources
References
- Ministry of Health, Kenya. (2023). Kenya Essential Medicines List 2023. Nairobi: Ministry of Health.
- Ministry of Health, Kenya. (2023). Kenya National Medicines Formulary, 1st Edition. Nairobi: Ministry of Health.
- Cipriani, A., et al. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs. The Lancet, 391(10128), 1357-1366.
- National Institute for Health and Care Excellence. (2022). Depression in adults: treatment and management (NG222). London: NICE.
- World Health Organization. (2023). Model List of Essential Medicines, 23rd Edition. Geneva: WHO.