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Re: Question for Ed

Posted by ed_uk on November 7, 2004, at 10:12:18

In reply to Question for Ed, posted by Emily Elizabeth on November 7, 2004, at 8:53:39

Yes, I've got Stockleys...
Escitalopram isn't in the textbook yet because it's too new. The interactions of escitalopram are believed to be the same as the interactions of citalopram. Here is what it says about citalopram and desipramine:

Citalopram caused an approximately 50% increase in the AUC of desipramine (the primary metabolite of imipramine) after a single 100mg oral dose of imipramine, and a reduction in the levels of the subsequently formed metabolite of desipramine.

Here is what the Medicines Compendium says...

Effect of escitalopram(Lexapro/Cipralex) on the pharmacokinetics of other medicinal products

Escitalopram is an inhibitor of the enzyme CYP2D6. Caution is recommended when escitalopram is co-administered with medicinal products that are mainly metabolised by this enzyme, and that have a narrow therapeutic index, e.g. flecainide, propafenone and metoprolol (when used in cardiac failure), or some CNS acting medicinal products that are mainly metabolised by CYP2D6, e.g. antidepressants such as ***desipramine***, clomipramine and nortryptyline or antipsychotics like risperidone, thioridazine and haloperidol. Dosage adjustment may be warranted.

Overall, I think plasma level monitoring could be a good idea, especially if you're taking a high dose of desipramine. Alternatively, you could ask for an electrocardiogram- to examine the effect of desipramine on the electrical activity of your heart.

All the best...
Ed


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