OBEXIL

*Major depression, Social anxiety disorder, Post-traumatic stress disorder, Generalized anxiety disorder:* Adult: 20 mg daily in the morning; max.50 mg per day. *Obsessive-compulsive disorder:* Adult: Initially 20 mg daily in the morning, increased in steps of 10 mg, dose to be increased gradually, increased to 40 mg daily; max.60 mg per day. Elderly: Initially 20 mg daily in the morning, increased in steps of 10 mg; max. 40 mg per day. *Panic disorder:* Adult: Initially 10 mg daily in the morning, increased in steps of 10 mg, dose to be increased gradually, increased to 40 mg daily; max.60 mg per day. Elderly: Initially 10 mg daily in the morning, increased in steps of 10 mg; max. 40 mg per day.

Hepatic or severe renal impairment, achlorhydria, high gastric pH, serotonin syndrome, cardiovascular disease, bleeding disorders, glaucoma, epilepsy (discontinue if new or increased seizures), ECT, diabetes, hyponatraemia, history of mania; discontinue if patient enters a manic phase. History of suicide-related events; monitor for suicidal idea-tion. Withdraw gradually.

MAOls, pimozide, linezolid, moclobemide, per-phenazine, risperidone, other antipsychotics, atomoxetine, classic antiarrhythmics, metoprolol, tramadol, tryptophan, lithium, phenytoin, TCADs, fosamprenavir, ritonavir, drug affecting liver enzymes (e.g. phenytoin, carbamazepine, phe-nobarbital, rifampicin), oral anticoagulants, NSAIDs, drugs that increase risk of bleeding, procyclidine, alcohol, St. Johns Wort, other SSR1s, SNRIs, 5HT1 agonists/triptans, other serotonergic drugs, tamoxifen. Liquid only: Drugs affecting gastric pH.

Arrhythmias, abnormal dreams, raised cholesterol, confusion, urinary incontinence, extrapyramidal reactions, orofacial dystonias, tinnitus, withdrawal reactions. Rare: Depersonalisation, neuroleptic malignant syndrome-like event, panic attacks, paradoxical increased anxiety during initial treatment of panic disorder (reduce dose), restless legs syndrome, hepatic disorders, hepatitis, peripheral oedema, priapism, glaucoma (very rare)