Drug Database
ES

escitalopram + clonazepam (Citapure Forte)

✓ Approved

A. N. Pharmacia Laboratories · GABRA1 · Small Molecule

What is escitalopram + clonazepam?

escitalopram + clonazepam is a small molecule developed by A. N. Pharmacia Laboratories. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesCitapure Forte
CompanyA. N. Pharmacia Laboratories
Drug ClassSmall Molecule
Molecular TargetGABRA1, GABRA2, GABRA3, GABRA4, SLC6A4
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, A. N. Pharmacia Laboratories

Mechanism of Action

Molecular Targets

escitalopram + clonazepam acts on 5 molecular targets:

GABRA1gamma-aminobutyric acid type A receptor alpha1 subunit (ECA4, EJM)
GABRA2gamma-aminobutyric acid type A receptor alpha2 subunit (EIEE78, DEE78)
GABRA3gamma-aminobutyric acid type A receptor alpha3 subunit (EPILX2)
GABRA4gamma-aminobutyric acid type A receptor alpha4 subunit ()
SLC6A4solute carrier family 6 member 4 (SERT1, 5-HTTLPR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

escitalopram + clonazepam is developed for 2 unique indications across 1 therapeutic area.

Therapeutic AreaConditionPhase
Psychiatric disordersBipolar I disorder✓ Approved
Psychiatric disordersGeneralised anxiety disorder✓ Approved

Related Research Articles

PubMedThe International journal of social psychiatry2026-08-30

Less Invasive Rapid Tranquilization in LMIC Emergency Settings: Comparison of Oral Risperidone Plus Clonazepam Versus Intramuscular Haloperidol in a Randomized Trial.

Baldaçara Leonardo L, de Freitas Railson Alves RA, Lacerda Acioly Luiz Tavares ALT, Périco Cintia de Azevedo Marques CAM

Psychomotor agitation is a common mental emergency that requires immediate, safe treatment. Intramuscular haloperidol is frequently used; however oral alternatives may be safer and more tolerated. In many low- and middle-income settings, resource constraints, cultural norms, and emergency department coercion shape agitation prescribing. This study compared the efficacy and safety of oral risperidone plus clonazepam versus injectable haloperidol for psychomotor agitation in primary psychotic patients. In this single-blind, randomized comparative trial, 260 patients (mean age 32.38; 95% CI [31.13-33.64], 119 males and 141 females) with severe psychomotor agitation in a general hospital emergency room were randomly assigned oral risperidone 3 mg plus clonazepam 3 mg (RC) or intramuscular haloperidol 5 mg. Behavioral Activity Rating Scale (BARS) agitation was measured at 30, 1, and 2 hr. The primary outcome was the percentage of patients reported as tranquil (BARS = 4) or tranquil/asleep (BARS = 2-4) at all time points, with an equivalency margin of ±20%. Secondary outcomes included tranquil/tranquil or asleep after 2 hr, restraint use, adverse effects (during the 2 hr of assessment), and necessity of additional medication after 1 hr. RC and IH were equally tranquil or sleeping at all time points for primary outcomes (adjusted ARR 9 percentage points, 95% CI -1.8 to +19.8). Neither tranquility at 2 hr nor extra medication were equal for secondary outcomes (adjusted ARR 15 p.p., 95% CI [1.35, 28.65]). At 2 hr, tranquil or asleep, restraint utilization, and side effects were equivalent. In conclusion, besides oral risperidone plus clonazepam met the prespecified criterion for equivalence to intramuscular haloperidol for the primary composite outcomes of maintaining tranquility or tranquility/asleep at all time-points during the 2-hr observation period, the equivalence was not demonstrated for all secondary outcomes. The oral regimen was associated with a greater need for additional medication. Therefore, the two regimens should not be considered fully interchangeable in all emergency presentations. We found that oral techniques may enable more humane, less invasive, and culturally acceptable emergency care in LMICs due to the social burden of injectable medication, which typically requires restraint.

PMID 42668395
Read full article →
PubMedSexual medicine2026-08-29

Differential signal strength of male sexual dysfunction associated with antidepressants: a disproportionality analysis of FAERS database.

Xu Jian J, Liu Kai K, Yang Xiaohu X, Kong Lingti L

Male sexual dysfunction (MSD) can induce or exacerbate depressive symptoms, and MSD caused by antidepressants may further aggravate the depressive symptoms of patients. However, real-world evidence regarding the association between different antidepressants and MSD remains insufficient. This study aims to systematically analyze the differences in the association between antidepressants and MSD, by utilizing the U.S. Food and Drug Administration Adverse Event Reporting System. Adverse drug events (ADEs) for male patients using antidepressants were retrieved. Adverse drug events were classified using the Standardized MedDRA Query. Disproportionality analysis was performed using reporting odds ratio (ROR), proportional reporting ratio (PRR), multi-item gamma-Poisson shrinker, and Bayesian confidence propagation neural network. The time-to-onset of MSD for each drug and the inclusion of MSD information in the drug labels were also analyzed. Among the 28 included drugs, 24 drugs reported MSD, 18 drugs simultaneously satisfied the positive signal criteria of all 4 algorithms. Sertraline had the highest number of MSD (988 cases), accounting for 6.22% of its total 15 875 cases. Escitalopram showed the strongest signal on all 4 algorithms [ROR: 13.67, PRR: 13.19, lower limit of 95% CI of empirical Bayes geometric mean (EBGM05): 12.19, lower limit of 95% CI of the information component (IC025): 3.59]. The time-to-onset of MSD for most antidepressant drugs followed an "Early failure" model. This study employed 4 algorithms to detect and evaluate potential association signals between antidepressants and MSD. Among the 28 antidepressants analyzed, 18 demonstrated significant associations with MSD. Beyond traditional selective serotonin reuptake inhibitors, the signal strength of MSD associated with other classes of antidepressants should not be overlooked.

PMID 42667010
Read full article →
PubMedClinical practice and cases in emergency medicine2026-08-26

Use of Corrected QT Cutoffs Derived from Biological Variation to Predict Adverse Events Due to Antipsychotic Drugs: Case Report.

Wu Alan H B AHB, Alamillo Melissa M, Kendrick Kayla K

The use of antipsychotic drugs can prolong the corrected QT (QTc) interval of the electrocardiogram and cause a life-threatening ventricular arrhythmia. There is no consensus as to what is considered normal or what cutoff indicates QTc prolongation. However, recent literature has described the biological variation of the QTc interval from healthy subjects, with researchers concluding that the best approach at establishing a normal range is to determine an individual baseline interval during health. A baseline QTc interval (460 milliseconds) had been determined for a 42-year-old female with a history of schizophrenia and depression who was prescribed antipsychotic drugs including escitalopram, olanzapine, haloperidol, clonazepam and divalproex over the course of four years. Over that time frame, she was admitted on 20 occasions with chest pain, but her QTc interval was at or above her baseline level. Acute coronary syndrome was ruled out for each episode. Her medication history was not altered or discontinued until her QTc was greatly prolonged at 530 milliseconds several years later. Fortunately, she did not suffer torsades de pointes. This case illustrates how results from biological variation studies and a personalized reference level can be helpful to alert physicians earlier of the presence of a potentially toxic condition.

PMID 42647942
Read full article →
PubMedFrontiers in neurology2026-08-26

Treatment patterns and access among people with epilepsy of childbearing potential in Peru.

Allen Samantha E SE, Wardle Melissa T MT, Moyano Luz M LM, Vilchez Percy P et al.

People with epilepsy of childbearing potential in low-resource settings face unique challenges related to anti-seizure medication (ASM) selection and access. These challenges may be particularly pronounced in regions where neurocysticercosis (NCC), a leading cause of acquired epilepsy worldwide, contributes substantially to the burden of disease. We characterized ASM prescribing patterns and factors associated with the use of higher-risk medications among people with epilepsy of childbearing potential in northern Peru. We analyzed data from females aged 15-49 years who were enrolled in a prospective, population-based epilepsy cohort in Tumbes, Peru, from 2006 to 2020. ASMs were categorized according to pregnancy-associated safety profiles as Lower-risk (lamotrigine, levetiracetam, oxcarbazepine, clonazepam, diazepam), Intermediate-High risk (carbamazepine, phenytoin, phenobarbital, topiramate), and Highest-risk (valproic acid). We evaluated ASM utilization, polytherapy, and factors associated with valproate use, the highest-risk medication. Among 1,975 individuals with epilepsy, 685 were of childbearing potential. Approximately one-third met criteria for probable or definite NCC (34.9%). Nearly all participants (98.6%) were prescribed carbamazepine, phenytoin, phenobarbital, or valproic acid, while use of newer-generation agents was rare. Most prescriptions (86.3%) were classified as Intermediate-High-risk, and 12.8% as Highest-risk. In multivariable analyses, prior ASM use and polytherapy were independently associated with receipt of valproate. In this population-based epilepsy cohort from northern Peru, ASM treatment among people of childbearing potential was overwhelmingly limited to older medications with an elevated risk of teratogenicity. These prescribing patterns likely reflect medication availability rather than clinical preference and highlight the challenges of implementing guideline-recommended epilepsy care in resource-constrained settings. Given the substantial burden of NCC-related epilepsy in this population, improving access to safer and more diverse ASM options may represent an important strategy for reducing treatment inequities among people with epilepsy of childbearing potential.

PMID 42643218
Read full article →
PubMedSeizure2026-08-25

Intramuscular midazolam versus intravenous clonazepam for prehospital treatment of generalized tonic-clonic seizures: A randomized double-blind non-inferiority trial.

Manai Hela H, Akari Sarra S, Kharraz Teycir T, Ghazali Hanen H et al.

Seizures are a common neurological emergency associated with significant morbidity and mortality. In the prehospital setting, intravenous (IV) benzodiazepines are commonly used as first-line therapy; however, establishing IV access may delay treatment in actively convulsing patients. Intramuscular (IM) midazolam provides a rapid alternative, but comparative evidence with IV clonazepam remains limited. To evaluate whether IM midazolam is non-inferior to IV clonazepam for the prehospital treatment of generalized tonic-clonic seizures. We conducted a prospective, randomized, double-blind, non-inferiority trial over 27 months (January 2023-March 2025) in a physician-staffed prehospital emergency medical service (SAMU 01, Tunis). Patients aged ≥14 years with witnessed tonic-clonic seizures lasting ≥5 min were randomized to receive either IV clonazepam 1 mg with IM placebo or IM midazolam 10 mg with IV placebo. The non-inferiority margin was set at 15%. The co-primary efficacy endpoints were treatment success (seizure cessation within 5 min without recurrence) and time from administration of the active study treatment to complete seizure cessation. Secondary outcomes included time from protocol initiation to seizure cessation, time from protocol initiation to administration of the active study treatment, time required to obtain intravenous access, failure to establish intravenous access within 3 min, treatment-related adverse events, endotracheal intubation, ICU admission, and 48-hour mortality. Analyses were performed according to both the intention-to-treat and per-protocol principles. Sixty-four patients were included (32 per group). Baseline characteristics were comparable. Treatment success was 75% with IM midazolam versus 62.5% with IV clonazepam (risk difference, +12.5 percentage points; 95% CI, -10.0 to +33.4), confirming non-inferiority because the lower confidence limit remained above the prespecified margin of -15 percentage points.The time from administration of the active study treatment to complete seizure cessation was significantly shorter in the IM midazolam group (1:42 ± 1:40 min vs 3:13 ± 1:41 min; p < 0.001). No significant differences were observed in adverse events or 48-hour outcomes, including endotracheal intubation (6%vs 9%; p = 0.74). IM midazolam was non-inferior to IV clonazepam with respect to treatment success and was associated with a shorter time to seizure cessation while maintaining a comparable safety profile.

PMID 42641490
Read full article →
PubMedThe British journal of psychiatry : the journal of mental science2026-08-25

Beyond control in psychiatric research: systematic review and meta-analysis of placebo treatment responses across major psychiatric conditions in citalopram and escitalopram RCTs.

Ahmadzad-Asl Masoud M, Jabbarinejad Roxana R, Shekouh Dorsa D, Moshfeghinia Reza R et al.

Placebos have historically been used as comparative tools in randomised controlled trials (RCTs), but their therapeutic effect, particularly in psychiatric conditions, warrant a more detailed exploration to improve research design and clinical practice. This systematic review and meta-analysis examines the factors influencing placebo treatment effects across major psychiatric disorders, including depression, anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). This PROSPERO registered systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify RCTs with at least one placebo and one medication arm (citalopram or escitalopram), across four major groups of psychiatric conditions. Data extraction focused on study characteristics, methodology, target condition, participant demographics and outcome measurements. Cohen's d effect sizes for placebo and medication groups were calculated, with random-effects model meta-analyses performed to assess heterogeneity and their correlates. The review included 80 studies with 312 outcome measures, involving 19 776 participants (7 to 91 years old). A large placebo response was observed (effect size: 1.01; 95% CI: 0.93-1.10) with significant heterogeneity (I2: 99.61%). Significant differences in placebo responses were noted across clinical conditions, independent of the medication type. PTSD and depressive disorders exhibited the highest placebo effect size (1.14 and 1.02, respectively), whereas OCD showed the lowest (effect size: 0.62, P < 0.01). Anxiety disorders displayed a moderately large placebo effect size (0.86), with significant variability among anxiety disorder subclasses, specifically noting the lowest placebo effect size in specific phobia (0.23, P < 0.01). The medication effect size (1.43) also demonstrated considerable heterogeneity (I2: 99.76%) but was not significantly different across psychiatric conditions (P = 0.61). Placebo response magnitude was larger in studies with more study arms (b: 0.181, P < 0.01) and younger mean age of the participant (b: -0.010, P < 0.01). Moreover, clinician-rated outcomes versus patient self-reports (effect size: 1.07 v. 0.76, P < 0.01), multicentre studies (p < 0.01) and using intention-to-treat data (effect size: 1.08 v. 0.86, P = 0.01) were associated with larger placebo effect size. This study used a unique approach to examine placebo responses from the same interventions across multiple major psychiatric disorders. We found substantial placebo responses across psychiatric conditions and significant heterogeneity, influenced by a range of study-related and demographic factors. The findings underscore the complexity of placebo responses and highlight the importance of considering these variances in both research design and clinical translation.

PMID 42639721
Read full article →

+8294 more articles available with a free account

Sign up free to view all articles →

Ask about escitalopram + clonazepam