Escitalopram, S-isomer of sitalopram is well tolerated, rapid onset efficacy and used in the tratment of depression and other psychiatric disorders in elderly. Escitalopram is highly serotonin specific and has minimal effect on the reuptake of other neurotransmitters. Insomnia, headache, tremor, nausea, flushing, sweating, diarrhea, sexual dysfunction have been reported to be adverse drug reaction during escitalopram therapy. In elderly patients, edema is an important health problem. Heart failure, renal failure, malabsorpsion, liver failure, allergic reactions, local inflammation and infections, burns, lymphatic obstruction increased capillary permeability, venous obstruction and drugs can cause peripheral edema. Antihypertensive medications, nonsteroidal anti-inflammatory agents, calcium channel blockers, corticosteroids, hormones, antibiotics, beta blockers and direct vasodilators are drugs that often cause peripheral edema. Edema has been reported rarely with psychiatric medications.