Escitalopram in Pregnancy and Breastfeeding
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Escitalopram (Lexapro TM)
Antidepressant. Selective serotonin reuptake inhibitor (SSRI) .S-enantiomer of racemic citalopram. Molecular weight: 414.40.

"Escitalopram is metabolized to S-DCT and S-didemethylcitalopram (S-DDCT). In humans, unchanged escitalopram is the predominant compound in plasma. At steady state, the concentration of the escitalopram metabolite S-DCT in plasma is approximately one-third that of escitalopram."

Oral administration of escitalopram to pregnant rats during the period of organogenesis resulted in decreased fetal body weight and associated delays in ossification at approximately >/=56 times the maximum recommended human dose [MRHD]* of 20 mg/day. The developmental no effect dose of 56 mg/kg/day is approximately 28 times the MRHD*. No teratogenicity was observed at any of the doses tested (as high as 75 times the MRHD*).

When female rats were treated with escitalopram during pregnancy and through weaning, slightly increased offspring mortality and growth retardation were noted at approximately 24 times the MRHD*. The no effect dose was 12 mg/kg/day which is approximately 6 times the MRHD*.

We were unable to locate reports describing the use of escitalopram during human pregnancy.

BREAST FEEDING: No reports were located describing the use of escitalopram during human lactation. However, racemic citalopram is excreted into human breast milk. The manufacturer recommends the decision whether to continue or discontinue either nursing or LEXAPRO therapy should take into account the risks of exposure for the infant and the benefits of LEXAPRO treatment for the mother.

*On a body surface area mg/m 2  basis


1. Physicians Desk Reference 57th ed. Montvale, NJ: Thomson PDR; 2004: 1304

Created: 1/10/2004
Updated: 1/10/2004

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