Major depressive disorder (MDD), obsessive compulsive disorder (OCD), panic disorder w/ or w/o agoraphobia, social anxiety disorder (SAD), PTSD, premenstrual dysphoric disorder (PMDD).
Dosage/Direction for Use
Adult MDD Initially: 50 mg once daily. OCD Initially: 50 mg once daily. Panic disorder Initially: 25 mg once daily, increased after 1 wk to 50 mg daily. SAD Initially: 25 mg once daily, increased after 1 wk to 50 mg daily. PTSD Initially: 25 mg once daily, increased after 1 wk to 50 mg daily. Maintenance: Dose may be increased, if necessary, in increments of 50 mg daily at intervals of at least a wk to a max of 200 mg daily. PMDD Initially: 50 mg once daily, either daily throughout the menstrual cycle or limited to the luteal phase of the menstrual cycle. Maintenance: Dose may be increased, if necessary, by 50 mg each menstrual cycle up to max of 150 mg daily when dosing daily throughout the menstrual cycle or 100 mg daily when dosing during the luteal phase of menstrual cycle.
Administration
May be taken with or without food.
Contraindications
Hypersensitivity. Concomitant use w/ MAOIs & pimozide.
Special Precautions
Serotoninergic syndrome. Increased suicide risk in early stages of recovery. History of mania/hypomania & bleeding disorders. SIADH secretion. Increase in ALT/AST. Avoid alcohol.
Cytochrome P450, other SSRIs or SNRIs, MAOIs, pimozide, thioridazine or mesoridazine, warfarin, lithium, NSAIDs, aspirin or other drugs affecting coagulation, St. John’s wort.
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