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Escitalopram is a medication developed by the Danish pharmaceutical company Lundbeck, that acts as a selective serotonin reuptake inhibitor or SSRI. It is typically used as an antidepressant to treat depression associated with mood disorders although also may be used in the treatment of body dysmorphic disorder and anxiety. In the United States, the drug is marketed under the name Lexapro® by Forest Laboratories, Inc. In Canada and Europe, the drug is marketed under the name Cipralex® by Lundbeck Canada, Inc. more...

Lactuca virosa
Levothyroxine sodium
Liothyronine Sodium
Lutropin alfa

Escitalopram oxalate is derived from the drug citalopram which is made up of two mirror-image isomers, only one of which is thought to be an effective medication. Lundbeck has split the isomers apart, taken the active isomer and has licensed it as the new drug escitalopram. Escitalopram is the pure S-enantiomer (single isomer) of the racemic bicyclic phthalane derivative citalopram.

Escitalopram was released shortly before the patent for citalopram was due to expire. The expiration of a patent means other companies can legally produce cheaper generic versions. Escitalopram is subject to a new patent. Critics have argued that escitalopram, and the subsequent marketing campaign to persuade mental health professionals to prescribe it, is a cynical ploy to promote sales of a virtually identical but considerably more expensive drug. In defence of the new drug, Lundbeck has claimed that the drug has additional benefits over the older citalopram and other antidepressant drugs on the market, mainly better tolerability .

Withdrawal symptoms

A possible withdrawal symptom from Escitalopram is a type of spontaneous nerve pulse, described by some patients as a feeling of small electric shocks, which may be accompanied by dizziness. These pulses may be short in duration, only milliseconds long, affect any region of the body, and recur up to several times a minute, throughout all waking hours. They can be increased by physical activity, but are not solely linked to muscular activity.


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Depression and the superwoman: celebrity superagent by day, she cried herself to sleep many nights. She wore her game face for years, until finally the
From Essence, 6/1/05 by Terrie Williams

The year I launched my public-relations company, I had no clue how to run a business. So when I asked God to bless me with my first client, I didn't expect Him to send me the biggest box-office draw in the world at the time--Eddie Murphy.

That was in 1987, after a stint as a full-time social worker had left me broke, emotionally depleted and yearning for another profession. Leaving behind job security and benefits was scary, but I knew I had to step out and take a risk. With no agency experience in public relations on my resume, I had gathered my nerve and set my sights on winning Eddie Murphy as a client. I sent letters to his home and office. I called. I followed up with more notes and conversations. Then in December I experienced one of the most powerful moments of my career: Eddie agreed to have me represent him. As nervous as I was about starting my business with such a high-profile celebrity, I knew this was God's confirmation that He would show me the way.

But there was enormous pressure. Whispers flew around the industry: Who was this unknown Black woman who'd landed Eddie Murphy? Until be signed with me, Eddie had never had a personal publicist, so for him to put his faith in me validated my agent. Although I was scared, I did whatever I had to do to get the business up and running. I put in long hours at the office, was constantly on the phone, sat in endless meetings. Months after Eddie hired me, clients such as Anita Baker, Jackie Joyner-Kersee and Miles Davis also signed on. In the following years, my business grew to include celebrities like Sean "P. Diddy" Combs, Janet Jackson and best-selling author Stephen King. But as my client list expanded, so did my level of exhaustion.

During the glamorous whirl of my days, I put on my game face for power lunches, film openings, press events and parties. But most nights I crawled home, overcome by fatigue. When I wasn't working, I was sleeping. Many days I was so overwhelmed by the length of my to-do list that I could barely get out of bed. I didn't know it then, but I'd already begun a downward spiral that, years later, would culminate in a crippling depression.

Depression isn't an easy subject for Black folks to talk about. It can be even harder if we've achieved a measure of visibility and success. We live in a society that is already inclined to think less of us, so once we make it into the big league, the last thing we want is to show a chink in the armor. The myth of the Invincible Sister leaves us little room to show weakness.

As a result, I hid my battle with depression for years. But when we fail to acknowledge and deal with deep-seated feelings of sadness and inertia, they can show up in destructive ways: in the form of anger, self-hatred, heart disease, substance abuse, overeating and irresponsible sexual behavior.

The Emptiness Inside

Few people knew that I struggled with depression. I had become so good at pretending everything was okay. By day I was the quintessential superwoman, the sister others called on to handle the details. In people's eyes, I had "made it." But when I drooped home after 14-hour workdays filled with meeting everyone else's needs but my own, my soul and spirit whispered otherwise.

The elder of two daughters of North Carolina sharecroppers, I was painfully shy as a child. Still I forced myself to step out of my comfort zone, like the time I ran for and served as class president in eighth grade. And as shy as I was, I remember being fairly happy growing up. I didn't experience anything like the pervasive sadness and bone-deep exhaustion of clinical depression until I was 24. [See sidebar for symptoms of clinical depression.] At the time, I was completing a master's in social work at Columbia University in New York. I wasn't unproductive--I completed each of my training shifts and classroom assignments, but the minute my work was finished, I escaped to my room and slid into a cocoon of sleep. I noticed that whenever I wasn't working, I was sleeping, sometimes for two or three hours in the middle of an afternoon. What was I running from? I had no idea. I just knew that something was deeply wrong.

It wasn't as if I walked around in a constant state of despondency. My 51 years have been filled with more mountaintop moments than I can recount. Many of my days have been punctuated with the love and enjoyment of family and friends. And in the two decades since I began my business, I've been blessed with a financial harvest that our foremothers could only dream of. Yet beneath the victories, the celebrations, the joyous refrains, there lived an emptiness, a painful sense of aloneness that became more acute during my late thirties. I wasn't in a serious relationship, and my biological clock was about to sound the final alarm. The reality that I might never find the love of my life or have children, coupled with the breakneck pace of my work, left me feeling drained and hopeless.

My mood-altering drug of choice was food. I ate when I felt empty, and that was most of the time. It's crazy how something so soothing can be so destructive. As I piled on weight, a few friends raised eyebrows. But whenever someone asked me, 'Are you okay?" I gave my game-face answer: "Everything's fine." During the day, as I raced between voice mails and E mails, meetings and press engagements, I rarely sat down for a meal. Instead I grabbed junk food on the go. When I finally arrived home from work, I'd reach for the first hit of comfort I could find--microwaved pound cake covered in strawberries, with Haagen-Dazs on the side. Not surprisingly, I did most of my overeating at night when I was alone with my thoughts. I did everything I could to silence those thoughts. I didn't want to face how much pain I was in.

Then in October 2003 I went through a series of major transitions. First I sold my business, though I remain involved as a partner. Then, after seven years of subleasing space in an office building, the agency was forced to move to another location. That big move coincided with another: My parents sold the home I grew up in, and following that sale they separated. Because the transaction happened very quickly, there was no time for me to take one last trip to the house and mourn the loss. That year I also lost two aunts whose constancy and love had provided a foundation for me during my entire life. Even the restaurant I'd frequented for years closed down its Saturday brunch! All at once I felt the ground shifting beneath my feet. So I did what I'd always done during a crisis: I slept.

Outwardly I still wore my game face. I wrote books, spoke at corporations, signed on new clients. But I woke up every morning with an almost overwhelming anxiety. I was in so much pain that for nine months I could barely get myself out of bed. Even when I did make it out of the house, I couldn't concentrate. There were times when I'd be flying across the country, and I'd say to myself. If this plane went down, I'd be okay with that. The anxiety was just too much. Some mornings I would put the covers over my head as the phone rang. It took all the strength I had just to get up and listen to another voice mail. Even when I managed to climb out of bed and return a few calls, there were many days when I'd get right back into bed. Two friends, frightened by the depression I'd fallen into, recommended that I call a psychiatrist. I realized that if I had been in physical pain, I would have seen a doctor. Why should emotional pain be any different? I finally picked up the phone.

A Spirit Out of Sync

This wasn't the first time I had reached out for help. To pull myself from my emotional slump in my twenties, I'd sought therapy. I'd realized then how unaware I was of all the feelings I'd experienced in my work as a publicist and as a certified social worker. Even after I began my PR agency, I had continued doing social work on the side, adopting a group home and counseling adults and at-risk youths. You name it, I heard it: physical and sexual abuse, abandonment, addiction. There was such deep pathology that sometimes I couldn't take it all in. Until my therapist asked me a question and the tears started flowing, I often had no idea how much I had been affected. I was always moving too fast to notice.

Now I began to see that it wasn't just as a social worker that I needed an outlet. As a celebrity publicist, I had absorbed people's problems for years. And spiritually and emotionally, it had taken its toll. I recalled an evening, shortly after my friends had convinced me to call a psychiatrist, when I went to receive an award. On the way there, I couldn't stop crying because I felt so low. God has always given me the strength to keep myself together in public, so by the time I walked onstage, I appeared fine. There I stood, smiling and wearing my mask--and inside I was dying. At that moment, I knew that this time I needed more than talk therapy. I needed medication.

Still it was jolting to hear my psychiatrist say the words: "You are clinically depressed." She prescribed Zoloft and Wellbutrin before settling on Lexapro to help rebalance the chemicals in my brain. Since then I've come to understand that my struggle with depression isn't just biochemical, it's also spiritual. In the years leading up to my breakdown, I was spiritually lacking. I was giving to everyone else and not honoring or replenishing myself. What do they say in airline videos? Put the oxygen mask over your own mouth first.

My sister once told me I was almost robotlike. I realize now she was really saying that I was being inauthentic. When I'd speak around the country at corporations and colleges, I would tell others how to live powerfully, yet I wasn't following my own advice. So often, what the teacher teaches is exactly what the teacher needs to hear. But I wasn't hearing it. No wonder my confidence plummeted, and I sank deeper into despair. My words and actions were completely out of sync. It's only when we speak from a place of truth and integrity that we can project with full power.

Accepting God's Challenge

I first mentioned my depression in 2002 in my third book, A Plentiful Harvest: Creating Balance and Harmony Through the Seven Living Virtues. But even then, I was afraid to speak candidly about my struggle. Then God said to me, "You have to tell others about your depression, Terrie." I can't begin to express how incredibly liberating it was to accept God's challenge. Today I don't have to hide. I don't have to pretend or lie. When we're courageous enough to tell the truth about our heartache, it's as if we're saying to others, "You're not in this by yourself." All we have to do is step outside our fear and pull off a layer of the mask. When I dared to do that, numerous friends and colleagues, both famous and not, began to pour out their stories to me.

Help others while you're hurting; that has been the lesson for me, When you reach out to someone else while you're in pain, you take the emphasis off you. Once when I was having a bad day, my friend Shellie, who can always sense when I'm hurting, took me to the group home that I'd adopted. It's amazing how stepping outside yourself to bless somebody else transforms you. Just spending an hour with kids who desperately need love and guidance lifted my spirit. Before that, I'd hardly been able to pick up my shoes off the floor.

A dear friend who also struggles with depression once told me, "Black people expect to be in pain every day." But the truth is, everybody on the planet is walking around with wounds. Think you know a person who doesn't have a problem? Think again. These days when I'm invited to speak at corporations about business and life principles, I'll often throw in a few words about depression, I'll say, "The reason I have the courage to stand up here and talk to you about this is because I know that half of you are probably on Prozac or Paxil. Raise your hand if you're sure!" As people laugh, hands go up. But afterward, several of these businesspeople, women and men whom others may never guess have experienced depression, will come up to me and share their struggle. I get the same reaction from college students and teens.

I've learned that dealing with depression isn't about escaping the feelings. It's about managing them--through talk therapy, medication, exercise, a closer relationship with God. We each have to find our own path to wholeness. Above all, we have to share where we are on the journey, because revelation leads to recovery. I now know that it is only through sharing our stories that we will find healing. When we open our lives, we find out that we're not standing on the ledge alone--we're surrounded by hundreds of others. That ledge is so crowded, the concrete is breaking! That's exactly why I want to use my voice and God's grace to create a sanctuary for people to tell their truths, understand their calling, and reach their full potential. As we unburden ourselves, one truth-telling session at a time, we move closer to the divine plan that the Creator has for each of us. There's a reason God allows us to walk through difficult circumstances; it's so that we can use our pain for the purpose of transformation--so we can lift each other up. If I hadn't survived the hell I found myself in two years ago, I wouldn't be able to tell you there's a miracle on the other side of the storm. We all have a testimony. This is mine.

Terrie Williams founded the Stay Strong Foundation to help youths and adults around the country share their experiences and break the chain of silent suffering. She told her story to Michelle Burford, a writer in New York.

RELATED ARTICLE: Recognizing Depression.

Depression or just a mild case of the doldrums? The American Psychological Association explains the difference this way: "Everyone feels sad or blue on occasion. But depressed people tend to feel helpless and hopeless, and to blame themselves for having these feelings. They may become overwhelmed and exhausted and stop participating in routine activities. They may withdraw from family and friends. Some may even have thoughts of death or suicide." If these symptoms persist for two or more weeks, the diagnosis is likely clinical depression.

Unfortunately, clinical depression is often misdiagnosed in Black women. "Our symptoms may not be unique, but they can manifest in culturally specific ways," explains Kennise Herring, Ph.D., coauthor of What the Blues Is All About. The myth of the Strong Black Woman only complicates things. "Black women often take great pride in persevering through adversity, so crying isn't a luxury we allow ourselves," Herring observes. Indeed, some Black women find it easier to express anger than sadness. "That's why depression is often manifested in irritability in Black women," says Herring. If you suffer from persistent feelings of pessimism, lethargy, irritability or sadness, it's important to get help.

SEEK THERAPY "We need to lift the veil of shame on getting professional help," says Tabi Upton, cofounder of LifeSource Empowerment Center in Chattanooga. "Just a onetime session with a therapist can begin a turnaround. If you can capture unhealthy thoughts soon enough, you can begin to redirect your emotions." Ask for referrals from relatives or friends or speak to your physician or minister. These organizations may also be able to help: National Mental Health Association, (800) 969-NMHA,; American Psychiatric Association, (888) 357-7924,

GET MOVING A Duke University study compares the antidepressant effect of jogging with that of Zoloft. After four months, patients treated with each approach were doing equally well. But a year later, a third of those treated successfully with Zoloft had relapsed, while more than 90 percent of the joggers were no longer depressed. And you don't have to be a triathlete to banish the blues. In the same Duke study, depressed patients between the ages of 50 and 77 derived just as much benefit from three 30-minute sessions of brisk walking each week as they did from medication.

CREATE A SISTER CIRCLE When you feel yourself falling into a funk, the instinct is to retreat. But consistent bonding with our girlfriends is like Wellbutrin for the soul. "Humans are creatures of community," says Upton. "We are healthiest when we're surrounded by loving people and in loving relationships."--M.B.

For information, write to Terrie Williams, Columbus Circle Station, P.O. Box 20227, New York NY 10023 or E-mail


COPYRIGHT 2005 Essence Communications, Inc.
COPYRIGHT 2005 Gale Group

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