Indications & Dose: DEPRESSION PO Adult 50-75mg in single/divided doses HS, may be increased to 150 or 200mg/day if needed, doses of 300mg/day in severe cases Child 16–18 yr: 10–25mg TID or as single dose HS, increase gradually to 150–200mg/day Elderly Initially 30–75mg/day in divided doses or as single dose HS | MIGRAINE Prophylactic therapy PO Adult Initially 10-25mg HS, usual dose 150mg/day Child Initially 0.25mg/kg/day HS, max 10mg/day | NOCTURNAL ENURESIS PO Child 7–10 yr: 10–20mg HS 3 months, 11–16 yr: 25–50mg HS 3 months

Precautions: History of epilepsy, elderly, thyroid disease, pheochromocytoma, glaucoma, history of urinary retention, concurrent electroconvulsive therapy, avoid abrupt withdrawal, anesthesia

ADR: Serious: ECG changes, arrhythmias, postural hypotension, hypersensitivity reactions, blood sugar level changes, mania, thrombocytopenia, blood disorders, hyponatremia, convulsions, movement disorders, acidosis, respiratory depression, blurred vision, Others: constipation, headache, dizziness, confusion, fatigue, nausea, fever, restlessness, increased appetite, weight gain, Sedation, dry mouth

DDI: Serious Morphine bioavailability and the degree of analgesia are increased, Benzatropine causes heat stroke, Insulin causes hypoglycemia, Linezolid/Dihydroergotamine causes serotonin syndrome, Altretamine causes severe orthostatic hypotension, Phenelzine causes very toxic and fatal reactions like serotonin syndrome, Fluconazole/Cimetidine/Fluvoxamine/Terbinafine increases drug level, Alcohol increases impairment of ability to drive, to handle dangerous machinery or to do other tasks, Noradrenaline/Adrenaline increases risk of hypertension & arrhythmia, Dextropropoxyphene moderately raises the drug levels, Sucralfate reduces drug absorption, Carbamazepine/Barbiturates reduces drug level

Diet: With/without food

Monitor: BP, ECG & suicidal thoughts