Adult Major depressive episodes 10 mg once daily for 2-4 wk, may be increased to a max of 20 mg daily. Panic disorder Initially 5 mg for the 1st wk, then increase to 10 mg daily. Max: 20 mg daily.
Concomitant use w/ MAOIs; patients who recently discontinued an SSRI & have been started on an MAOI. May start treatment 14 days after discontinuing treatment w/ a MAOI & at least 7 days should elapse after discontinuing treatment before starting a MAOI. Some cases presented w/ features resembling serotonin syndrome. Childn.
Discontinue use if seizure develops & in patients entering manic phase. History of mania/hypomania. Increased anxiety symptoms at the start of treatment (paradoxical anxiety). Avoid in patients w/ unstable epilepsy. Controlled epilepsy; DM, cutaneous bleeding abnormalities, history of bleeding disorders; patients on electroconvulsive therapy. Monitor patients for suicide risk in 1st few wk of treatment. Concomitant use w/ medicines known to affect platelet function (eg, atypical anti-psychotics & phenothiazines, TCAs, aspirin & NSAIDs). Hepatic impairment. Elderly.
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