- 10 SCitao-S F. C. Tablets 10mg

054980

GMP G-10977

PIC/S GMP

17-1

Escitalopram as oxalate .......................................................................................................................10mg

10 20 2-4 6

20 Escitalopram

( 65 )

18 Escitalopram 18

Ccr 30ml/min. 2 5

10 CYP2C19 CYP2C19 2

5 10 ( )65 omeprazole cimetidineescitalopram 10

escitalopram 1 2

escitalopramMAO

pimozideQT long QT syndrome

Escitalopram QT interval 20 escitalopramQT QT QT

escitalopram(Randomized controlled trial RCT)

(Retrospective cohort study) (Conventional) (Atypical)(dementia-related psychosis)

1818

SSRI Selective Serotonin Re-uptake InhibitorsS

2

SSRIS

SSRIS

SSRI / SSRIS S

SSRI /S

/

Major depressive disorder,MDD

escitalopram 24

65

escitalopram

/SSRI /SNRIS S

SSRI SIADHS

SSRIS

SSRIS

Phenothiazines Tricyclic antidepressants Acetylsalicylic acidnon-steroidal anti-inflammatory NSAID ticlopidine dipyridamoleS

ECT SSRIS

MAO-ASerotonin Syndrome escitalopram

MAO-AMAO

Serotonin Syndromeescitalopram Sumatriptan triptans tramadol

tryptophan SSRIS

Serotonin Syndrome

SSRIS

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Hypericum perforatumSSRI Hypericum perforatum S

escitalopram 25%15%

/

22 3

escitalopram

1.

MAOIS

SSRI MAOI Non-selective monoamine S S

oxides inhibitor SSRI MAOIS S

Serotonin SyndromeEscitalopram MAOI Escitalopram MAOI 14S S

MAOI RIMA moclobemide 1S

MAOI Escitalopram 7S

Pimozidepimozide 2mg citalopram 40mg/ 11 pimozide AUC

Cmax Pimozide citalopram QT 10msecC

pimozide citalopram pimozide QT omeprazole cimetidine escitslopram

10

MAO-A moclobemideSerotonin Syndrome escitalopram MAO-A

Selegiline Selegiline MAO-B Serotonin Syndrome

Selegiline 10 / Citalopram

tramadol,sumatriptan triptansSerotonin Syndrome

SSRIS

tricylics , SSRI phenothiazines , thioxanthenes ,butyrophenones S

mefloquine bupropion tramadolLithium Tryptophan

SSRI Lithium Tryptophan SSRIS S

Hypericum perforatumSSRI Hypericum perforatumS

escitalopramescitalopram

Escitalopram

Escitalopram QT interval 20 QTescitalopram escitalopram

Torsades de poites

2.escitalopram

Escitalopram CYP2C19 CYP3A4 CYP2D6S-DCT demethylated escitalopram

CYP2D6Escitalopram omeprazole CYP2C19 escitalopram ( 50%)Escitalopram cimetidine( ) escitalopram ( 70%)

escitalopram CYP2C19 omeprazole fluoxetine fluvoxaminelansoprazole ticlopidine cimetidine

escitalopramEscitalopramEscitalopram CYP2D6 escitalopram

flecainide,propafenone metoprolol CYP2D6CNS desipramine,clomipramine,nortryptyline

risperidone , thioridazine , haloperidol desipraminemetoprolol CYP2D6escitalopram CYP2C19 CYP2C19

escitalopram( )

escitalopramescitalopram

SSRI/SNRI

(<24 )escitalopram /

SSRI(Persistent pulmonary hypertension in the newborn,PPHN) 1000

5 1000 1 2

Escitalopram

escitalopram

SSRIS

SSRI S

escitalopram

self-limiting 1~2

escitalopram Placebo-correct

SSRI escitaloprams

Placebo-correct1/10 1/100, 1/10 1/1000,1/100

1/10000,1/1000 1/10000

SSRI /S

QT-

SSRI /SNRIS S

/

escitalopram

escitalopramescitalopram

400 800 escitalopram

Escitalopram/

QT /

1.Pharmacotherapeutic group

ATC-code N 06 AB10

Escitalopram serotonin 5-HT100

escitalopram- -

Escitalopram 5-HT ,5-HT , D D receptors 1 21A 2 1 2

-adrenoceptors histamine H1, muscarine cholinergic,benzodiazepine, opioidreceptors

Escitalopram citalopram S-R- S-

8 escitalopram

Escitalopram 10mg 20mg 8escitalopram 20mg citalopram 40mg escitalopram

escitalopram 20mg 10mg

escitalopram 10mg citalopram 20mg 24escitalopram

8 Open-label escitalopram 10 20274 escitalopram 36

escitalopram 36

Escitalopram 10 5-20mg escitalopram10-40mg racemic citalopram

0000000

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escitalopramcitalopram5% citalopram escitalopram

3 12 escitalopram24 escitalopram5

10 20escitalopram20 / Paroxetine 20 /

escitalopram 5 10 paroxetine2 p 0.05670 escitalopram 341

58.1% 40.2% CGI-I 1 2 24.8% 12.9%CGI-I 1 2 P 0.001

4 escitalopram10-20mg/ 5mg/

3 8 421 escitalopram 41947.5% 28.9% P 0.01 37.1% 20.8%

12paroxetine escitalopram 10mg/ paroxetine 20mg/ escitalopram 510 20mg P 0.01 paroxetine

24 76 12 open label treatment 373escitalopram 20mg/

12 20 escitalopram -- NIMH-OCS

10 p 0.005 20 p 0.001escitalopram

2416

24 -- NIMH-OCS

10 / p 0.01 20 / p 0.001 escitalopram 10p 0.05 20 p 0.01 escitalopram

10 20 escitalopram 16 escitalopram24

escitalopram 10 p 0.014 20p 0.001

escitalopram OCD escitalopram SF-36SDS2.

mean T 4 racemic citalopram, escitalopram 80%max

V /F 12~26L/kg escitalopramd.

80%

Escitalopram demethylated didemethylatedN-oxide

demethyl escitalopram 28-31% didemethyl5%

Escitalopram CYP2C19 demethylatedCYP3A4 CYP2D6

t 30 Cl 0.6L/min1/2 oral

escitalopram

1050nmol/L 20~125nmol/L

65Escitalopram AUC 50%

Escitalopram Child-Pugh A B 260%

Racemic citalopram CLcr10-53 ml/min

CYP2C19 escitalopram CYP2D6

Escitalopram escitalopram citalopramcitalopram

escitalopramescitalopram citalopram

escitalopram AUC 3 48 S- AUC

citalopram 6-7 biogenic amines

citalopramescitalopram citalopram

phospholipidosis

AUCAUC

2-1000

25

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1/10

1/100,1/10

1/10000,1/1000

(

)

1/1000,1/100

0000000

()..................

ADH

UC-092-1307-3