Indications & Dose: DEPRESSION PO Adult Initially 50mg OD increase by 50mg/day weekly, max 200mg/day if needed Child 12-18 yr: Same as adult dose Elderly Initially 25mg OD, if tolerated increase by 25mg/day increments q2-3days 50-100mg/day max 200mg/day, if needed | PANIC DISORDER PO Adult Initially 25mg/day, increase to 50mg/day after 1 wk max 200mg/day | POST-TRAUMATIC STRESS DISORDER PO Adult Initially 25mg/day, increase to 50mg/day after 1 wk max 200mg/day | PREMENSTRUAL DYSPHORIC DISORDER PO General Initially 50mg OD throughout menstrual cycle/limited to the luteal phase of menstrual cycle, as appropriate. If no response, increase dose by 50mg per menstrual cycle up to a max 150mg/day when dosing throughout menstrual cycle or up to 100mg/day when dosing during luteal phase only | SOCIAL ANXIETY DISORDER PO Adult Initially 25mg/day, increase to 50mg/day after 1 wk max 200mg/day

Precautions: serotonin syndrome/NMS, sexual dysfunction, SIADH, hyponatremia, hepatic/renal impairment, comorbidities, seizure disorder, uric acid nephropathy, drug therapy

ADR: Serious: hypertonia, abnormal vision, Others: dizziness, fatigue, headache, insomnia, somnolence, libido, ejaculatory disturbances, diaphoresis, nausea, vomiting

DDI: Serious Levothyroxine efficacy is reduced, Phenytoin increases drug level, Propafenone increases drug levels & adverse effects, Warfarin increases INR, Sibutramine/Amitriptyline leads to serotonin syndrome

Diet: With/without food

Monitor: Nutritional intake & weight, mental status for depression, suicide ideation, anxiety, social functioning, mania, panic attacks, growth in pediatrics