Major depressive disorder Initial & maintenance dose: 60 mg once daily. Max: 120 mg daily. Diabetic peripheral neuropathic pain 60 mg once daily. Max: 120 mg daily in divided doses. Generalized anxiety disorder 30 mg once daily, may be increased up to 60 mg. Patient w/ co-morbid major depressive disorder 60 mg once daily, may be increased up to 90-120 mg.
Mania, bipolar disorders &/or seizures. Patients w/ increased IOP & risk of narrow-angle glaucoma. Monitor BP in patients w/ known HTN & heart disease. Monitor for suicidal ideation/behavior especially w/ patients <25 yr. Haemorrhage, known bleeding tendencies. Hyponatraemia. W/drawal symptoms on treatment discontinuation. Akathisia/psychomotor restlessness. Concomitant use w/ SSRIs, SNRIs, TCAs, triptans, St. John's wort, anticoagulants, NSAIDs, ASA. Fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltose insufficiency. May affect ability to drive & use machines. Renal impairment. Hepatitis/increased hepatic enzyme. Pregnancy. Not recommended during lactation. Not to be used in childn & adolescents <18 yr. Elderly.
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