Cipralex® is an antidepressant that contains the active ingredient Escitalopram contains. It is one of the selective serotonin reuptake inhibitors (SSRIs) and, via an increase in the serotonin level in the central nervous system, leads to a drive-increasing and anxiety-reducing effect.
In addition to being used to treat major depression, it is also prescribed for various anxiety disorders.
Cipralex® is not approved for use in children and adolescents under 18 years of age.
Read more on this topic: The role of serotonin / neurotransmitters in depression
The active ingredient escitalopram contained in Cipralex® has an antidepressant effect. For this reason, the drug is used in the context of major depression. It should be noted, however, that the effect is delayed and that long-term therapy is necessary for the preparation to be effective.
In addition, Cipralex® is also prescribed for various anxiety disorders. On the one hand, it is used to treat panic disorders. These are characterized by recurring panic attacks, which often occur in combination with agoraphobia (fear or severe discomfort in certain places).
In addition, the preparation is also used for social anxiety disorders (social phobias), whereby the patient feels strong fears during social contact (especially with strangers).
Another indication of Cipralex® are generalized anxiety disorders. The feeling of fear has spread to all areas of everyday life. Patients are characterized by inner restlessness, easy fatigue and easy irritability. In addition, they show difficulty concentrating.
Read more about this under Generalized anxiety disorder
Finally, Cipralex® can also be prescribed for obsessive-compulsive disorder. Obsessive-compulsive thoughts and actions place a heavy burden on the patient and his environment.
Read more about this under
- Obsessive-compulsive disorder
- Types of Obsessive Compulsive Disorder
Active ingredient and its effects
The active ingredient in Cipralex® Escitalopram acts as a selective serotonin reuptake inhibitor (SSRI) at the synapses between two nerve cells in the central nervous system. To transmit signals, a nerve cell releases various neurotransmitters into the synaptic gap, which bind to receptors in another nerve cell and transmit the signal. The remaining neurotransmitters are then broken down and taken up again into the nerve cells via the transporters. Escitalopram blocks these serotonin transporters and selectively inhibits the reuptake of serotonin. Due to the increased serotonin level in the synaptic gap, the signal transmission between two nerve cells is lengthened and strengthened.
The exact cause and development of depression is not yet fully understood. However, a deficiency in the neurotransmitters serotonin and noradrenaline seems to be a major contributor to the development of depression. By increasing the serotonin level in the central nervous system during treatment with escitalopram, an anxiety-reducing, mood-enhancing and drive-enhancing effect is achieved.
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Side effects of Cipralex
Like all antidepressants, Cipralex® is also characterized by a wide range of potential side effects. However, it should be taken into account that the group of selective serotonin reuptake inhibitors (SSRIs), which includes the active ingredient escitalopram, is significantly better tolerated than the long-preferred tricyclic antidepressants.Basically, the majority of side effects occur primarily at the beginning of therapy with Cipralex® and gradually decrease in the course of treatment.
Very often (in more than 10% of patients) headaches and nausea occur during therapy. In addition, patients often report weight changes. The majority of patients show an increase in weight due to an increase in appetite. However, in rare cases, weight loss is also possible. In addition, complaints in the gastrointestinal tract (diarrhea, constipation, vomiting) and sleep disorders are possible. In addition, treatment with SSRIs often leads to sexual dysfunction with a loss of libido (sexual desire). Ejaculation and menstrual cycle disorders can also occur. Numerous other side effects are possible and can be found in the package insert.
Read more on this topic on our main page Citalopram
After the absorption of Cipralex® in the form of tablets, the active ingredient is metabolized in the liver and then distributed in the body. Interactions with numerous other drugs can occur.
Cipralex® should under no circumstances be combined with MAO inhibitors (including moclobemide, selegiline, tranylcypromine). There is a risk of very serious and sometimes life-threatening side effects. Among other things, the development of a serotonin syndrome is to be feared due to the greatly increased serotonin level in the central nervous system. For this reason, the combination of Cipralex® with other active ingredients that increase serotonin levels (serotonergic drugs) should be avoided if possible.
Since the active ingredient escitalopram leads to a prolongation of the QT time in the ECG also in the heart, the preparation should not be combined with other drugs that prolong the QT time. There is a risk of very serious and life-threatening cardiac rhythm disorders.
Read more about this under
- Medicines for cardiac arrhythmias
The metabolism of escitalopram by specific liver enzymes can also cause interactions with other active substances that are activated or broken down by these enzymes. Therefore caution should be exercised when combining escitalopram with omeprazole, fluvoxamine, ticlopidine and cimetidine.
Read more about this under Omeprazole
The usual dose for treating depression is 10 mg. If the product does not work or does not work well, the dose can be increased by up to 20 mg. No study results are available for doses above 20 mg. An onset of antidepressant effects can be expected after a few weeks at the earliest. As a rule, the drug therapy must be continued for a period of several months and years to ensure the success of the therapy.
The therapy of anxiety disorders with Cipralex® usually also starts with 10 mg. Treatment with 5 mg is only started for panic disorders (with or without agoraphobia). The dosage can also be increased up to a dose of 20 mg, depending on the patient.
Read more about this under Therapy for agoraphobia
The dose should be adjusted accordingly in patients with severe renal impairment or mild to moderate hepatic impairment. For this reason, doses of 5 mg are initially indicated for patients over 65 years of age.
The preparation can be taken independently of meals. Abrupt discontinuation of the drug should be avoided, as this can lead to a wide range of typical withdrawal symptoms (dizziness, sleep disorders, nausea, vomiting, tremors, etc.).
Cipralex® is available in pharmacies in two different doses (10 mg and 20 mg) in the form of tablets with a prescription. You can purchase three different pack sizes (20, 50, 100).
A pack of 20 with 10 mg Cipralex® tablets can be bought for around 30 euros. The 50-pack in the same dosage costs around 45 euros. The large pack of 100 is available for a price starting at around 85 euros.