Depsit (Escitalopram) is the most commonly prescribed antidepressant. It is Selective Serotonin Reuptake Inhibitor and mainly produces its effects in CNS. This short survey on Depsit (Escitalopram) was conducted during my bachelors in Physiology (2016). There isn't any valuable information available on internet regarding this brand of escitalopram. This report may serve as a useful tool for all healthcare professionals.

1. U n i v e r s i t y O f K a r a c h i
2016
Brand Name:
Depsit
Generic Name:
Escitalopram Oxalate
Chemical Name:
Escitalopram (S-Citalopram)
DRUG SURVEY
REPORT
By: Asifa Nisar Bhutto
B.Sc. (H) Physiology
H-1323007
Fundamentals Of Pharmacology

2. 1
ABSTRACT:
Introduction: Depsit (Escitalopram) is the most commonly prescribed antidepressant. It is S-
enantiomer of citalopram, and has better effect. Depsit is highly selective SRI and produces its
effects in CNS by inhibiting serotonin reuptake by binding to serotonin transport protein.
Object: This study was designed to find out the most commonly experienced side effects,
efficacy and major causes of using depsit. Methodology: A questionnaire based cross-sectional
survey was conducted among the local residents of Karachi, Pakistan. The questionnaire was
composed of 14 basic questions filled by a total of 20 respondents. Conclusion: This study
shows that the use of this medicine is strictly under prescription, and no malpractice was found.
Most of the people have gastro-psychiatric over lapse, are and chronic users (using since 4-5
years). No prominent side effects are found except increase in appetite leading to weight gain,
sleepiness and lethargy.

3. 2
Table of Contents
 Object
 Introduction
 Pharmacodynamics
 Pharmacokinetics
 Side Effects
 Methodology
 Results
 Discussion
 Conclusion
 References

4. 3
OBJECT:
To find out the frequency and causes of use, side effects, and effectiveness of tab. Depsit.
INTRODUCTION:
Tab. Depsit is composed of Escitalopram oxalate. Escitalopram is a selective serotonin (5-
hydroxytryptamine, 5-HT) reuptake inhibitor (SSRI) and it is FDA approved drug for the treatment of
adults and children over 12 years of age with major depressive disorder (MDD) and certain anxiety
disorders: general anxiety disorder (GAD), social anxiety disorder (SAD), obsessive-compulsive disorder
(OCD), and panic disorder. SSRIs are also effective in reducing the symptoms of PMS (Premenstrual
syndrome) and for treating tension headaches and migraine.
Pharmacodynamics:
All SSRIs inhibit reuptake of serotonin (5-HT) into presynaptic serotonergic neurons, an action that
increases the availability of serotonin at the synapse and, ultimately, enhances serotonergic function in
the central nervous system. This mechanism of action depends on the binding of drug to the serotonin
transporter protein. It has minimal effects on norepinephrine and dopamine neuronal reuptake.
Escitalopram has no or very low affinity for serotonergic (5-HT1-7) or other receptors including alpha-
and beta-adrenergic, dopamine (D1-5), histamine (H1-3), muscarinic (M1-5), and benzodiazepine
receptors. Escitalopram also does not bind to, or has low affinity for, various ion channels including Na+ ,
K+ , Cl- , and Ca++ channels. Antagonism of muscarinic, histaminergic, and adrenergic receptors has
been hypothesized to be associated with various anticholinergic, sedative, and cardiovascular side
effects of other psychotropic drugs.

5. 4
Pharmacokinetics:
Biotransformation of escitalopram is mainly hepatic. Maximum concentration of escitalopram is
achieved after 3-4 hours of administration. Its half-life is about 27-33 hours and bioavailability is 80%.
Escitalopram is metabolized by the cytochrome P450 (CYP) isoenzymes CYP2C19, CYP2D6 and CYP3A4.
The principle metabolite is S-demethylcitalopram (S-DCT) that is eliminated in urine. The
pharmacokinetics of this drug is not affected by concurrent intake of food.
*Depsit (Escitalopram Oxalate) is contraindicated for patients taking Monoamine Oxidase Inhibitors
(MAOIs) due to its potent interactions with this drug (serotonin syndrome).
SIDE EFFECTS:
Gastrointestinal- Nausea, diarrhea, increased appetite, taste disturbances.
Central Nervous System- Sleeplessness, fatigue, drowsiness, unusual excitement, confusion.
Heart- Fast or irregular heartbeat, postural hypotension
Psychiatric: Increased appetite, lethargy, anxiety, suicidal thoughts.
Genitourinary- Impotence, ejaculation disorder.
Eye and ENT- Inflammation of the Para nasal sinuses, seeing things or hearing voices that do not exist
(hallucinating). Miscellaneous- Increased sweating, weight gain, fever, and severe muscle stiffness.
Methodology:
A short survey was conducted to find out the uses, effectiveness and side effects of Depsit. The sample
size catered was 20 and data was collected by distributing a Performa (based on 14 basic questions)from
local residents of Karachi, specifically, patients from DUHS (Ojha campus) OPD, sub department of:
Neurology, and from Jinnah Postgraduate Medical Centre (JPMC) medical unit 4 (M4) and medical unit 7
(M7), after informed verbal consent. Patients who were interested in giving their psychiatric problems
history were given preference, whereas, those who had serious hepatic/renal impairment were
excluded from the study.

6. 5
Result:
Data was analyzed in MS Excel version 14. Following results are obtained:
Fig 1: Most of the subjects using depsit are young. Fig. 2: Showing that no. of female users is greater.
Figure 1 this figure is showing the level of education of participants. The minimal qualification noted was
matriculation, and maximal was graduation, including two doctors. The qualification was found to be
independent of age.
12
8
Age
18-25 years
26-35 years
5
15
Gender
Male
Female
5
9
6
Matric
Intermediate
Graduation
0 2 4 6 8 10
Qualification

7. 6
Figure 2 This figure shows the duration for which depsit was used. Minimum time of usage found in this study is 1
week, while most of the patients were taking this drug for 4-5 years.
Figure 3 This pie chart shows the major complains for which this drug was prescribed, and it reveals that most of
the patients were having GIT problems.
5
9
6
Complain
Headache
GIT Problems
Multiple Complains
1
6
4
9
Less than 1
month
1-6 months Till 1 year More than 1
year
0
1
2
3
4
5
6
7
8
9
10
Duration
Numberofpeople Duration Of Use

8. 7
Figure 4 This chart highly supports the effectiveness of depsit. 19 out of 20 patients found this drug very effective
for their problem.
Figure 5 This chart shows the effect of this drug on the body weight of user. 12 patients noticed an increase in
their weight, 8 patients had no fluctuation in weight, while nobody noticed the decrease in weight after using
this medicine
1
19
Effectiveness
Not effective
Vey Effective
8
12
Effect On Weight
No effect
Increase in weight

9. 8
Figure 6 Awareness regarding the actual use of depsit was independent of patient’s level of education. However,
12 out of 20 patients were well aware of its uses.
Figure 7 This figure shows the daily dosage of medicine taken by the patients. Majority of the patients
were given the minimum dose (5mg/day).
8
12
Knowledge regarding actual
use of this drug
Don't know
Well aware
11
9
Daily Dosage
5 mg
10 mg

10. 9
Figure 10; chart showing other drugs used by the patients along with depsit.
Figure 8 This chart shows that most of the patients think that this drug is addictive.
7
12
1
No GIT Drugs Migraine Drugs
0
2
4
6
8
10
12
14
Use of other drugs
Numberofpeople
Other Drugs
4
16
Addiction
Not Addictive
Addictive

11. 10
Figure 9 This figure shows the effect of depsit on the overall mood of patient, and it reveals that most of the
patients felt a positive change in their mood.
Figure 10 This chart shows that 19 out of 20 patients experienced hypersomnia induced by this medicine.
No effect
Positive
Negative
0
5
10
15
20
2
17
1
Effect
Numberofpeople
Effect On Mood
1
19
Do you feel sleepy after taking
Depsit?
No Yes

12. 11
Figure 11 This figure shows the number of people that experienced side effects related to Central Nervous
System.
Figure 12 This pie chart shows that only a small number of patients encountered Gastrointestinal Tract Problems
after taking depsit.
14
6
CNS Side Effects
No
Yes
18
2
GIT Side Effects
No
Yes

13. 12
Figure 13 This figure shows the number of patients (15) that reported an increase in appetite during the course of
this medicine.
5
15
Increase in Appetite
No Yes

14. 13
Discussion: Out of 20 subjects that took part in study, only 5 were male and 15 female which gives
a rough idea about higher prevalence of depression in females as compared to males. Most of the
patients were young. Minimum age recorded is 18 years and maximum is 34 years. The least
qualification found is matric (5 subjects), and highest is graduation (6 Subjects), while 9 subjects were
intermediate pass. The level of education of subjects was independent of their age. Only 1 participant
used this medicine for a duration of 1 week (minimum time recorded) while 2 participants (female) were
using this medicine for almost 4 years, and 1 male participant was on this drug for last 5 years (highest
duration recorded). 5 patients complained of problems related to headache, dizziness & vision, 6
patients were having GI upsets (bloating, diarrhea, constipation, epigastric pain), and majority of
patients (9) reported multiple problems (like, abdominal pain, breathlessness, excessive sweating etc.)
due to which this drug was prescribed to them. Depression may give rise to several other problems like
IBS, Panic attacks (misinterpreted as acute asthma), and several other health issues. So, in order to cure
these conditions, underlying cause (depression) must be treated and eliminated. 19 out of 20 patients
rated this drug as an excellent remedy for their problem. A large number of people (12/20) noticed a
rapid elevation in their weight as they continued using this medicine, while 8 patients had no effect. This
might be due to increased appetite as a result of calmness. Hypersomnia may also contribute to this
factor. Nobody reported a decrease in weight related to this drug. 8/20 patients showed no significant
knowledge regarding the actual cause for which depsit is prescribed, while 12 were well aware about its
use. The knowledge of patients was independent of their age and qualification. Daily dosage prescribed
was found to be 5mg/day and 10mg/day, a maximum dosage of 20mg/day was not taken by any subject.
Majority of the participants were also prescribed omeprazole (risek), husk, and other GIT drugs, 7
patients were not using any other drug with depsit, while only 1 patient (female) was taking muscle
relaxant (Nuberol fort), and migraine drugs (miral, epival). With the exception of 3 patients, all the
participants noticed a positive, stabilizing effect of depsit on their mood. 16/20 patients reported
addiction of this medicine, and 19/20 said that they felt extreme sleepiness after taking depsit. Side
effects related to CNS (shaking, restlessness, coordination problem) were faced by only 6 patients.
Gastrointestinal upset (bloating, increased stool frequency) was noticed only in 2 patients. Increased
appetite and lethargy are two most common side effect of depsit experienced by 15 and 16 patients
respectively. 2 /20 patients reported sleepiness and bloating as severe side effects due to which the
therapy was not continued.
Conclusion:
The use of depsit (escitalopram) is highly controlled among the patients included in this study.
Almost all the participants were well aware of its use and reported this medicine as a highly
effective antidepressant. Depsit is not only prescribed in Neurology or Psychiatry departments,
it is frequently given to IBS patients and those having random episodes of panic attacks. The
use of this medicine is safe. No severe side effects were observed.

15. 14
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1):34-9 [PubMed]
3. B. Søgaard, H. Mengel, N. Rao, F. Larsen. The Pharmacokinetics of Escitalopram After Oral and
Intravenous Administration of Single and Multiple Doses to Healthy Subjects. The journal of clinical
pharmacology Volume 45, Issue 12, December 2005 , Pages 1400–1406
4. Rao N. The clinical pharmacokinetics of escitalopram. Clin Pharmacokinet. 2007;46(4):281-90.
[PubMed]
5. WJ Burke, A Bose - The Journal of clinical psychiatry, 2002 - psychiatrist.com
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