📋 Indications & Clinical Dosage
*Major depression:*
Adult: Initially 10 mg once daily; can be adjusted according to response from 5 to 20 mg once daily.
Elderly: Initially 5 mg once daily; increased if necessary up to 20 mg once daily.
⚠️ Precautions & Warnings
Moderate to severe renal or hepatic impairment, bleeding disorders, cirrhosis of the liver, history of mania, history of seizures, unstable epilepsy, seizures; discontinue treatment in patients who develop seizures or if there is an increase in seizure frequency, elderly. Treatment can be stopped abruptly.
🔄 Drug Interactions
Dapoxetine, dosulepin, linezolid, methylene blue, MAOIs, pimozide, tryptophan, urokinase, strong CYP2D6 inhibitors, broad CYP inducers, 5HTI, agonists/triptans, tramadol, other serotonergic drugs, St. Johns wort, antipsychotics, domamine, antagonists, lithium, drugs that reduce seizure threshold, anticoagulants, NSAIDs, and other drugs affecting platelet function, drugs that cause hyponatraemia
⚠️ Adverse Reactions / Side Effects
Dizziness, diarrhoea, constipation, abnormal dreams, nausea, pruritus, vomiting, flushing, night sweats. Rare: Bleeding disorders, neuroleptic malignant syndrome (discontinue), serotonin syndrome, sexual dysfunction (with higher dose)
🤰 Pregnancy & Lactation Safety
Pregnancy Risk:
Avoid unless potential benefit outweighs risk
Lactation / Breastfeeding:
Contraindicated