Extended-Release Escitalopram
Mechanism of Action
Selectively inhibits serotonin reuptake, increasing serotonergic neurotransmission.
Indications
Extended-Release formulation. Major depressive disorder, generalized anxiety disorder, panic disorder, PTSD. First-line for Earth-sickness syndrome with depressive features, isolation syndrome, and circadian disruption-related mood disorders in lunar residents.
Dosing
Standard (Earth)
See Extended-Release prescribing information. 10-20 mg once daily.
Lunar Protocol
Start at 10mg. Response assessment at 4-6 weeks. In lunar residents, higher rates of concurrent sleep disruption may require concurrent sleep-focused interventions. Monitor for QT prolongation (baseline ECG). Weight gain side effect particularly concerning given lunar nutrition challenges. Sexual side effects may worsen interpersonal relationships in confined habitats — discuss before starting.
Storage
Standard
Room temperature, protect from moisture.
Lunar (Radiation + Temperature)
Stable at 15-25°C. Radiation shielded. 3-year expiry — maintain 12-month supply. High demand expected in lunar mental health population. Tablet form stable.
Supply Chain & Lunar Pharmacy Notes
High demand medication. Mental health conditions underreported in early lunar population — actual need may exceed estimates. Stock SSRIs generously. Sertraline is an acceptable alternative with equivalent efficacy.
Drug Interactions
MAOIs (serotonin syndrome — potentially fatal), QT-prolonging drugs, anticoagulants.
Contraindications
Concurrent MAOI use, long QT syndrome.
Side Effects
Nausea, insomnia, sexual dysfunction, weight gain, QT prolongation.
Lunar Alternatives
Sertraline (similar efficacy), mirtazapine (also helps sleep), bupropion (no sexual side effects, helps with motivation).