P-1091 - Administration of escitalopram and bilateral ankle oedema: case report

Abstract

Introduction Escitalopram(ESC) is a selective serotonin reuptake inhibitor(SSRI)which has been shown to be an effective treatment for major depressive. Objectives We report a case of a 52-years old female patient who after approximately 1 month of therapy with ESC, progressively titrated up to 20mg/day developed a bilateral ankle oedema, which resolved completely within the first week following its discontinuation. Aims To prove the connection between ESC and cutaneous effects(oedema). Methods The patient was suffering from depressed mood most of the day, fatigue, diminished ability to think or concentrate, insomnia,feelings of worthlessness and periods of sweating, chest pain, dizziness and fear of losing control. Escitalopram was administered with a initial dose of 10 mg once a day that over a period of one week increased to 20 mg once a day. Three weeks later the patient's depressive symptoms improved a signifigantly. However she complained about a swelling in both her feet and she could hardly wear her shoes.The clinical examination revealed a bilateral ankle oedema. Clinical and laboratory evaluations (electrocardiogram, ultrasonography, blood tests, albumins, renal and thyroid function tests, serum electrolytes)didn’t reveal any pathological findings. There was also no history of areterial hypertension, and after repeated measurements her arterial pressure was within normal range. Results Escitalopram was discontinued and the patient was treated with paroxetine 20 mg/day.The patient's oedema resolved completely within ten days after escitalopram discontinuation with no reappearing. Conclusions Bilateral ankle oedema it's a rare side effect during therapy with ESC.