![]() Use in Patients with Concomitant Illness: Use caution in patients with diseases or conditions that produce altered metabolism or hemodynamic responses ( 5.10).Angle Closure Glaucoma: Angle closure glaucoma has occurred in patients with untreated anatomically narrow angles treated with antidepressants.Interference with Cognitive and Motor Performance: Use caution when operating machinery ( 5.8). ![]() ![]() Abnormal Bleeding: Use caution in concomitant use with NSAIDs, aspirin, warfarin or other drugs that affect coagulation ( 5.7).Hyponatremia: Can occur in association with SIADH ( 5.6).Activation of Mania/Hypomania: Screen patients for bipolar disorder ( 5.5).Seizures: Prescribe with care in patients with a history of seizure ( 5.4).Discontinuation of Treatment with escitalopram: A gradual reduction in dose rather than abrupt cessation is recommended whenever possible ( 5.3).If concomitant use of escitalopram with other serotonergic drugs is clinically warranted, patients should be made aware of a potential increased risk for serotonin syndrome, particularly during treatment initiation and dose increases ( 5.2). If such symptoms occur, discontinue escitalopram and initiate supportive treatment. Serotonin Syndrome: Serotonin syndrome has been reported with SSRIs and SNRIs, including escitalopram, both when taken alone, but especially when co-administered with other serotonergic agents (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St.
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