Symptomatic treatment of depression including depression accompanied by symptoms of anxiety. Obsessive compulsive disorder (OCD). Panic disorder w/ or w/o agoraphobia. Prevention of initial relapse of depressive episodes or recurrence of further depressive episodes.
AdultDepression Initially 50 mg daily as single dose, may be increased after several wk in 50-mg increments at least 1 wk interval up to max: 200 mg once daily. Elderly Initially 12.5-25 mg. OCD 50 mg, may be increased up to 200 mg at least 1 wk interval. Panic disorder Initially 25 mg once daily, may be increased to 50 mg once daily after 1 wk. Further increments of up to 200 mg daily. Doses ≥150 mg should not exceed for 5 wk.
Seizure; activation of mania/hypomania. Monitor for clinical worsening, suicidality or unusual changes in behavior; depressed patients w/ suicidal tendencies during early phase of treatment. Not to be used w/in 14 day of MAOIs discontinuation. Avoid concomitant use w/ alcohol. Concomitant use w/ electroconvulsive therapy. Hepatic cirrhosis. Hepatic & severe renal impairment. Pregnancy. Not recommended during lactation. Childn & adolescents.
Not to be used w/ MAOIs. Reduced clearance & prolonged t½ of IV diazepam. Increased plasma conc & risk of adverse effects w/ digitoxin & warfarin. Increased plasma conc of TCAs & class 1C antiarrhythmics, propafenone, flecainide. Concomitant use w/ lithium.
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