Indications & Dose: DEPRESSION PO Adult Initially 50/100mg OD HS, max 300mg/day. Total daily dose >150mg given in 2 or 3 divided doses | OBSESSIVE-COMPULSIVE DISORDER PO Adult IR: Initially 50mg/day HS may be increased by 50mg q4-7day intervals as tolerated usual dose range 100-300 mg/day (doses >100mg given in 2 divided doses), max 300mg/day. ER: Initially 100mg/day HS may be increased by 50mg increments q1wk usual dosage range 100-300 mg/day max dose 300mg/day Child 8-18 yrs: Initially 25mg/day, increase by 25mg q4-7days based on response, max 100mg BID. Doses >50mg are given in 2 divided doses. | SOCIAL ANXIETY DISORDER PO Adult Initially 100mg OD increased as necessary, max 300mg/day

Precautions: Epilepsy/history of such disorders, CVD/history of bleeding disorders, DM, angle-closure glaucoma, hepatic/renal impairment, elderly, mania, suicidal tendency

ADR: Serious: tachycardia, bradycardia with ECG changes, suicide/suicidal ideation, tremor, HTN, orthostatic hypotension, edema, manic/psychotic reactions, hypersensitivity reaction, Others: hypokinesia/hyperkinesia, weight gain/loss, chills, fever, flu like symptoms, hot flashes, palpitations, dizziness, drowsiness, headache, insomnia, nervousness, anxiety, apathy, sinusitis, nausea, vomiting, diarrhea, constipation, dyspepsia, dry mouth, anorexia, sexual dysfunction, hypertonia, myoclonus, twitching, cough, dyspnea, diaphoresis

DDI: Serious Lidocaine (IV) clearance is reduced by drug, Rosiglitazone/Mexiletine AUC is increased by drug, Tolbutamide clearance reduced, Alcohol increases in sedation, Selegiline leads to CNS disturbances, Carbamazepine levels and signs of toxicity increases, Sildenafil levels and vascular effects are increases by drug, Buspirone levels increases & effects reduced by drug, Haloperidol levels increases & its adverse effect also increases, Tizanidine levels increases & leads to increase in hypotensive & adverse effects, Clomipramine/Alosetron/Clozapine/Dihydroergotamine/Duloxetine/Glimepiride/Imipramine/Methadone/Olanzapine/Propranolol/Risperidone/TCAs/Thioridazine levels increases by drug, Theophylline levels rapidly increases by drug, Benzodiazepines levels reduces by drug, Zolmitriptan/PPIs metabolism is inhibited by drug

Diet: With/without food

Monitor: Depression, suicide ideation, anxiety, social functioning, mania, panic attacks, akathisia, weight gain/loss, sleep, LFTs (prior to beginning therapy)