What is amitriptyline?   Amitriptyline is a tricyclic antidepressant with sedative effects. Amitriptyline affects certain chemical messengers (neurotransmitters) that communicate between brain cells and help regulate mood. Amitriptyline is a prescription medicine used to treat symptoms of depression. Amitriptyline may also be used for purposes not listed in this medication guide.   Warnings You should not use amitriptyline if you have recently had a heart attack. Do not use amitriptyline if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. You may have thoughts about suicide when you first start taking an antidepressant such as amitriptyline, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Before taking this medicine You should not use this medicine if you are allergic to amitriptyline, or: if you have recently had a heart attack. Do not use amitriptyline if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. To make sure amitriptyline is safe for you, tell your doctor if you have ever had: bipolar disorder (manic-depression) or schizophrenia; mental illness or psychosis; liver disease; heart disease; a heart attack, stroke, or seizures; diabetes (amitriptyline may raise or lower blood sugar); glaucoma; or problems with urination. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Tell your doctor if you are pregnant or breastfeeding. Amitriptyline is not approved for use by anyone younger than 12 years old. How should I take amitriptyline? Take amitriptyline exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. If you need surgery, tell your surgeon you currently use amitriptyline. You may need to stop for a short time. Do not stop using amitriptyline suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using amitriptyline. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. Dosing information Usual Adult Dose for Depression: OUTPATIENTS: -Initial dose: 75 mg orally per day in divided doses; this may be increased to 150 mg/day (if needed) -Maintenance dose: 40 to 100 mg orally per day -Maximum dose: 150 mg/day Alternate outpatient treatment regimen: 50 to 100 mg orally as a single dose at bedtime; this may be increased by 25 or 50 mg as needed at bedtime to a total of 150 mg/day INPATIENTS: -Initial dose: 100 mg orally per day -Maintenance dose: 40 to 100 mg orally as a single dose at bedtime -Maximum dose: 300 mg/day Comments: -Dose increases should preferably be made in the late afternoon or at bedtime due to the sedative effect. -The full therapeutic effect may take as long as 30 days to develop. -Maintenance doses should be reduced to the lowest amount that will maintain relief of symptoms when satisfactory improvement has been obtained. -Maintenance therapy should be continued for 3 months or longer to lessen the possibility of relapse. Use: Relief of symptoms of depression Usual Geriatric Dose for Depression: 10 mg orally 3 times a day AND 20 mg orally once a day at bedtime Comments: -The full therapeutic effect may take as long as 30 days to develop. -Elderly patients should be monitored carefully and serum levels obtained as clinically appropriate. -Dose adjustments should be made according to clinical response. Use: Relief of symptoms of depression Usual Pediatric Dose for Depression: 12 years or older: 10 mg orally 3 times a day AND 20 mg orally once a day at bedtime Comments: -The full therapeutic effect may take as long as 30 days to develop. -Dose adjustments should be made according to clinical response. Use: Relief of symptoms of depression   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amitriptyline can be fatal. Overdose symptoms may include irregular heart rhythm, feeling like you might pass out, seizures, or coma. What to avoid Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with amitriptyline. Avoid driving or hazardous activity until you know how amitriptyline will affect you. Your reactions could be impaired. Avoid exposure to sunlight or tanning beds. Amitriptyline can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Amitriptyline side effects Get emergency medical help if you have signs of an allergic reaction to amitriptyline: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: signs of a blood clot - sudden numbness or weakness, problems with vision or speech, swelling or redness in an arm or leg; unusual thoughts or behavior; a light-headed feeling, like you might pass out; chest pain or pressure, pain spreading to your jaw or shoulder, nausea, sweating; pounding heartbeats or fluttering in your chest; confusion, hallucinations; a seizure (convulsions); painful or difficult urination; severe constipation; easy bruising, unusual bleeding; or fever, chills, sore throat, mouth sores. Common amitriptyline side effects may include: constipation, diarrhea; nausea, vomiting, upset stomach; mouth pain, unusual taste, black tongue; appetite or weight changes; urinating less than usual; itching or rash; breast swelling (in men or women); or decreased sex drive, impotence, or difficulty having an orgasm. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect amitriptyline? Taking amitriptyline with other drugs that make you sleepy can worsen this effect. Ask your doctor before taking amitriptyline with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures. Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Tell your doctor about all your other medicines, especially: other antidepressants; medicine to treat depression, anxiety, mood disorders, or mental illness; cold or allergy medicine (Benadryl and others); medicine to treat Parkinson's disease; medicine to treat stomach problems, motion sickness, or irritable bowel syndrome; medicine to treat overactive bladder; or bronchodilator asthma medication. This list is not complete. Other drugs may affect amitriptyline, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.  

What is amoxapine? Amoxapine is a tricyclic antidepressant that is used to treat symptoms of depression, anxiety, or agitation. Amoxapine may also be used for purposes not listed in this medication guide. Warnings You should not use amoxapine if you have recently had a heart attack. Do not use amoxapine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Before taking this medicine You should not use amoxapine if you are allergic to it, or if: you have recently had a heart attack. Do not use trimipramine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others. Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. Tell your doctor if you have ever had: heart disease, stroke, or seizures; kidney disease; schizophrenia or other mental illness; diabetes (amoxapine may raise or lower blood sugar); bipolar disorder (manic depression); if you are receiving electroshock treatment; glaucoma; or problems with urination. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Tell your doctor if you are pregnant or breastfeeding. Amoxapine is not approved for use by anyone younger than 18 years old. How should I take amoxapine? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. If you take amoxapine once daily, take your dose at bedtime. It may take up to 3 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. Do not stop using amoxapine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using trimipramine. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amoxapine can be fatal. Overdose symptoms may include seizure (convulsions), acidosis, or coma. What should I avoid while taking amoxapine? Drinking alcohol with amoxapine can cause side effects. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Amoxapine side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: skin rash, fever; uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement); pounding heartbeats or fluttering in your chest; chest pain or pressure, pain spreading to your jaw or shoulder; sudden numbness or weakness (especially on one side of the body), slurred speech, problems with vision or balance; or severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out. Common side effects may include: drowsiness; constipation; dry mouth; or blurred vision. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   Amoxapine dosing information Usual Adult Dose for Depression: Initial dose: 50 mg orally 2 to 3 times a day Maintenance dose: 100 mg orally 2 to 3 times a day Maximum dose: 600 mg/day Comments: -Increases above 300 mg/day should be made only if 300 mg/day has been ineffective during at least two weeks. -Hospitalized patients who have been refractory to antidepressant treatment and who have no history of convulsive seizures may have dosage increased cautiously up to 600 mg/day in divided doses. -This drug may be given in a single daily dose, not to exceed 300 mg, preferably at bedtime. -Doses above 300 mg should be given in divided doses. Uses: -Relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depression -Depression accompanied by agitation or anxiety Usual Geriatric Dose for Depression: Initial dose: 25 mg orally 2 to 3 times a day Maintenance dose: 50 mg orally 2 to 3 times a day Maximum dose: 300 mg/day Comments: -Once an effective dosage is established, this drug may be administered in a single bedtime dose, not to exceed 300 mg. -Recommended maintenance dosage is the lowest dose that will maintain remission. -If symptoms reappear, the dosage should be increased to previous level until symptoms are under control. Use: -Relief of symptoms of depression in patients with neurotic or reactive depressive disorders as well as endogenous and psychotic depression -Depression accompanied by agitation or anxiety   What other drugs will affect amoxapine? Using amoxapine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Many drugs can affect amoxapine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is citalopram? Citalopram is an antidepressant belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Citalopram is a prescription medicine used to treat depression. Citalopram is also used to treat major depressive disorder (MDD). Warnings Citalopram can cause a serious heart problem. Call your doctor right away if you have chest pain, fast or pounding heartbeats, shortness of breath, and sudden dizziness. You should not use citalopram if you also take pimozide, as the combination can cause problems with your heart rhythm. Do not use citalopram if you have used a MAO inhibitor in the past 14 days (such as isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, or tranylcypromine) or have received a methylene blue injection. A fatal reaction may occur. People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Do not stop using citalopram without first asking your doctor. Before taking this medicine You should not use citalopram if you are allergic to citalopram or escitalopram (Lexapro), or if you also take pimozide. Do not use citalopram within 2 weeks before or after using an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, and tranylcypromine. To make sure citalopram is safe for you, tell your doctor if you have ever had: heart problems; long QT syndrome (in you or a family member); high blood pressure; a stroke; bleeding problems; sexual problems; liver or kidney disease; narrow-angle glaucoma; seizures or epilepsy; bipolar disorder (manic depression); or an electrolyte imbalance (such as low levels of potassium, magnesium, or sodium in your blood). Tell your doctor if you also use stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with citalopram could cause a serious condition called serotonin syndrome. People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior. Taking this medicine during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop citalopram without asking your doctor. You should not breastfeed while taking . How should I take citalopram? Take citalopram exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Measure liquid medicine with the supplied measuring device (not a kitchen spoon). Your symptoms may not improve for up to 4 weeks. Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated. If you stop using citalopram suddenly, you may have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Ask your doctor before stopping the medicine. Store at room temperature away from moisture and heat. Dosing information Usual Adult Dose for Depression: Initial dose: 20 mg orally once a day Maintenance dose: 20 to 40 mg orally once a day Maximum dose: 40 mg orally per day Comments: -The initial dose may be increased if necessary to 40 mg once a day after at least 1 week of therapy. -Doses of 60 mg/day did not demonstrate an advantage in efficacy over 40 mg/day doses. -Acute episodes of depression may require several months or more of sustained pharmacologic therapy Use: Treatment of depression Usual Geriatric Dose for Depression: Over 60 years of age: Recommended dose: 20 mg orally once a day Comments: -Doses of 60 mg/day did not demonstrate an advantage in efficacy over 40 mg/day doses. -Acute episodes of depression may require several months or more of sustained pharmacologic therapy. Use: Treatment of depression   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking citalopram? Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with citalopram may cause you to bruise or bleed easily. Avoid drinking alcohol. Avoid driving or hazardous activity until you know how citalopram will affect you. Your reactions could be impaired. Citalopram side effects Get emergency medical help if you have signs of an allergic reaction to citalopram: hives, rash, blisters; fever, joint pain; difficult breathing; swelling of your face, lips, tongue, or throat. Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: a light-headed feeling, like you might pass out; blurred vision, eye pain or redness, seeing halos around lights; fast or pounding heartbeats, pain or fluttering in your chest, shortness of breath, and sudden dizziness (like you might pass out); a seizure; manic episodes - racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative; severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors; or low blood sodium - headache, confusion, problems with thinking or memory, weakness, feeling unsteady. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Common citalopram side effects may include: sexual problems; dizziness, drowsiness; dry mouth, thirst, increased sweating or urination; loss of appetite, nausea, diarrhea, constipation; feeling anxious, agitated, or shaky; feeling weak or tired; sleep problems (insomnia); yawning; increased muscle movement; nosebleeds, heavy menstrual bleeding; or cold symptoms such as stuffy nose, sneezing, sore throat. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect citalopram? Citalopram can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV. Tell your doctor about all your current medicines. Many other drugs can affect citalopram, especially: cimetidine; a blood thinner (warfarin, Coumadin, Jantoven); a diuretic or "water pill"; lithium; St. John's wort; tramadol; or tryptophan (sometimes called L-tryptophan). This list is not complete and many other drugs may affect citalopram. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is duloxetine? Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI). Duloxetine affects chemicals in the brain that may be unbalanced in people with depression. Duloxetine is used to treat major depressive disorder in adults. It is also used to treat general anxiety disorder in adults and children who are at least 7 years old. Duloxetine is also used in adults to treat nerve pain caused by diabetes (diabetic neuropathy), or chronic muscle or joint pain (such as low back pain and osteoarthritis pain). Some brands of duloxetine are also used to treat fibromyalgia (a chronic pain disorder). Drizalma is for treating fibromyalgia only in adults. Cymbalta may be used to treat fibromyalgia in adults and children at least 13 years old. Warnings Do not take duloxetine within 5 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others. A dangerous drug interaction could occur. People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Tell your doctor right away if you have any sudden changes in mood or behavior, or thoughts about suicide. Do not stop using duloxetine without first talking to your doctor. Before taking this medicine You should not use duloxetine if you are allergic to it. Do not take duloxetine within 5 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, or tranylcypromine. A dangerous drug interaction could occur. Tell your doctor if you also use stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with duloxetine could cause a serious condition called serotonin syndrome. Duloxetine is not approved for use by anyone younger than 7 years old. To make sure duloxetine is safe for you, tell your doctor if you have: heart problems, high blood pressure; liver or kidney disease; slow digestion; a seizure; bleeding problems; sexual problems; narrow-angle glaucoma; bipolar disorder (manic depression); drug addiction or suicidal thoughts; or if you drink large amounts of alcohol. People with depression or mental illness may have thoughts about suicide. Some young people may have increased suicidal thoughts when first starting a medicine to treat depression. Stay alert to changes in your mood or symptoms. Your family or caregivers should also watch for sudden changes in your behavior. Taking an SNRI antidepressant during late pregnancy could increase your risk of excessive bleeding after you give birth, and may cause serious medical complications in the baby. However, stopping the medicine may not be safe if you have a relapse of depression. Do not start or stop duloxetine without asking your doctor. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of duloxetine on the baby. If you are breastfeeding, tell your doctor if you notice drowsiness, feeding problems, and slow weight gain in the nursing baby. How should I take duloxetine? Take duloxetine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Taking duloxetine in higher doses or more often than prescribed will not make it more effective, and may increase side effects. Swallow the capsule whole and do not crush, chew, break, or open it. You may take duloxetine with or without food. Your blood pressure will need to be checked often. Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated. Your symptoms may not improve for up to 4 weeks. Do not stop using duloxetine suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Ask your doctor before stopping the medicine. Store at room temperature away from moisture and heat. Dosing information Usual Adult Dose for Depression: Initial dose: 20 mg to 30 mg orally 2 times a day Maintenance dose: 60 mg per day, given either once a day OR 30 mg orally 2 times a day Maximum dose: 120 mg/day. Usual Adult Dose for Fibromyalgia: Initial dose: 30 mg orally once a day for at least 1 week Maintenance dose: 30 to 60 mg orally once a day. Usual Adult Dose for Generalized Anxiety Disorder: Initial dose: 60 mg orally once a day Maintenance dose: 60 to 120 mg orally once a day Maximum dose: 120 mg/day. Usual Adult Dose for Pain: Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day. Usual Adult Dose for Neuropathic Pain: Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day. Usual Adult Dose for Chronic Pain: Initial dose: 30 to 60 mg orally once a day Maintenance dose: 60 mg orally once a day. Usual Geriatric Dose for Generalized Anxiety Disorder: Initial dose: 30 mg orally once a day for at least 2 weeks Maintenance dose: 60 mg orally once a day Maximum dose: 120 mg/day. Usual Pediatric Dose for Generalized Anxiety Disorder: 7 to 17 years: -Initial dose: 30 mg orally once a day for at least 2 weeks -Maintenance dose: 30 to 60 mg orally once a day -Maximum dose: 120 mg/day. Usual Pediatric Dose for Fibromyalgia: 13 years and older: -Initial dose: 30 mg orally once a day for at least 1 week -Maintenance dose: 30 to 60 mg orally once a day.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include vomiting, dizziness or drowsiness, seizures, fast heartbeats, fainting, or coma. What should I avoid while taking duloxetine? Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with duloxetine may cause you to bruise or bleed easily. Avoid driving or hazardous activity until you know how duloxetine will affect you. Your reactions could be impaired. Dizziness or fainting can cause falls, accidents, or severe injuries. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Drinking alcohol may increase your risk of liver damage, especially if you take Drizalma. Duloxetine side effects Get emergency medical help if you have signs of an allergic reaction to duloxetine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Tell your doctor right away if you have new or sudden changes in mood or behavior, including new or worse depression or anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, more active or talkative, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: pounding heartbeats or fluttering in your chest; a light-headed feeling, like you might pass out; easy bruising, unusual bleeding; vision changes; painful or difficult urination; liver problems - right-sided upper stomach pain, itching, dark urine, jaundice (yellowing of the skin or eyes); low blood sodium - headache, confusion, problems with thinking or memory, weakness, feeling unsteady; or manic episodes - racing thoughts, increased energy, decreased need for sleep, risk-taking behavior, being agitated or talkative. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Common duloxetine side effects may include: drowsiness; nausea, constipation, loss of appetite; dry mouth; or increased sweating. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect duloxetine? Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective. Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with duloxetine may cause you to bruise or bleed easily. Many drugs can interact with duloxetine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you use.

What is escitalopram? Escitalopram is an antidepressant belonging to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). It affects chemicals in the brain that may be unbalanced in people with depression or anxiety. Escitalopram is used to treat major depressive disorder in adults and adolescents at least 12 years old. Escitalopram is also used to treat anxiety in adults. Warnings You should not use escitalopram you also take pimozide or citalopram (Celexa). Do not use escitalopram within 14 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Do not stop using escitalopram without first asking your doctor. Before taking this medicine You should not use this medicine if you are allergic to escitalopram or citalopram (Celexa), or if: you also take pimozide. Do not use escitalopram within 14 days before or 14 days after you have used an MAO inhibitor. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with escitalopram and cause a serious condition called serotonin syndrome. To make sure escitalopram is safe for you, tell your doctor if you have ever had: liver or kidney disease; seizures; low levels of sodium in your blood; heart disease, high blood pressure; a stroke; bleeding problems; sexual problems; bipolar disorder (manic depression); or drug addiction or suicidal thoughts. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Escitalopram is not approved for use by anyone younger than 12 years old. Ask your doctor about taking this medicine if you are pregnant. Taking an SSRI antidepressant during late pregnancy may cause serious medical complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine without your doctor's advice. If you are pregnant, your name may be listed on a pregnancy registry to track the effects of escitalopram on the baby. If you are breastfeeding, tell your doctor if you notice drowsiness, agitation, feeding problems, or poor weight gain in the nursing baby. How should I take escitalopram? Take escitalopram exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Take escitalopram at the same time each day, with or without food. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated. Your doctor will need to check your progress on a regular basis. A child taking escitalopram should be checked for height and weight gain. Do not stop using escitalopram suddenly, or you could have unpleasant withdrawal symptoms. Follow your doctor's instructions about tapering your dose. Store escitalopram at room temperature away from moisture and heat. Dosing information Usual Adult Dose for Generalized Anxiety Disorder: Initial dose: 10 mg orally once a day; increase if necessary after at least 1 week of treatment to 20 mg once a day Maintenance dose: 10 to 20 mg orally once a day Maximum dose: 20 mg orally once a day Comment: Treatment should be periodically reassessed to determine the need for ongoing treatment; efficacy beyond 8 weeks has not been systematically studied. Use: Acute treatment of generalized anxiety disorder Usual Adult Dose for Depression: Initial dose: 10 mg orally once a day; increase if necessary after at least 1 week of treatment to 20 mg once a day Maintenance dose: 10 to 20 mg orally once a day Maximum dose: 20 mg orally once a day Comments: -Acute episodes may require several months or longer of sustained pharmacological therapy beyond response to the acute episode. -Patients should be periodically reassessed to determine the need for maintenance treatment. Use: Acute and maintenance treatment of major depressive disorder Usual Geriatric Dose for Depression: Recommended dose: 10 mg orally once a day Use: Acute and maintenance treatment of major depressive disorder Usual Pediatric Dose for Depression: 12 years and older: -Initial dose: 10 mg orally once a day; increase if necessary after at least 3 weeks of treatment to 20 mg once a day -Maintenance dose: 10 to 20 mg orally once a day -Maximum dose: 20 mg orally once a day Comments: -Acute episodes may require several months or longer of sustained pharmacological therapy beyond response to the acute episode. -Patients should be periodically reassessed to determine the need for maintenance treatment. Use: Acute and maintenance treatment of major depressive disorder   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What to avoid Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with escitalopram may cause you to bruise or bleed easily. Avoid alcohol. Avoid driving or hazardous activity until you know how escitalopram will affect you. Your reactions could be impaired. Escitalopram side effects Get emergency medical help if you have signs of an allergic reaction to escitalopram: skin rash or hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights; racing thoughts, unusual risk-taking behavior, feelings of extreme happiness or sadness; pain or burning when you urinate; (in a child taking escitalopram) slow growth or weight gain; low levels of sodium in the body - headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady; or severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Common escitalopram side effects may include: painful urination; dizziness, drowsiness, tiredness, weakness; feeling anxious or agitated; increased muscle movements, feeling shaky; sleep problems (insomnia); sweating, dry mouth, increased thirst, loss of appetite; nausea, constipation; yawning; nosebleed, heavy menstrual periods; or decreased sex drive, impotence, or difficulty having an orgasm. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect escitalopram? Using escitalopram with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Tell your doctor about all your current medicines, especially a blood thinner such as warfarin, Coumadin, or Jantoven. Many drugs may interact with escitalopram, and some drugs should not be used at the same time. Tell your doctor about all your current medicines and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

What is fluocinonide? Fluocinonide is a potent corticosteroid that prevents the release of substances in the body that cause inflammation. Fluocinonide topical (for the skin) is used to treat inflammation and itching caused by plaque psoriasis and skin conditions that respond to steroid medication. Fluocinonide topical is available in a cream, gel, ointment, and solution. Warnings Fluocinonide may affect growth in children and teens in some cases. They may need regular growth checks. Talk with your doctor. Use care when using fluocinonide topical on a large part of the skin or where there are open wounds. Do not use fluocinonide on cuts, scrapes, damaged skin, or on open wounds. Do not use tight-fitting diapers or plastic pants if treated part is in the diaper area. This may cause more of the medicine to be absorbed into the body. Before taking this medicine You should not use fluocinonide topical if you are allergic to it. To make sure fluocinonide is safe for you, tell your doctor if you have ever had: any type of skin infection; a skin reaction to any steroid medicine; liver disease; or an adrenal gland disorder. Steroid medicines can increase the glucose (sugar) levels in your blood or urine. Tell your doctor if you have diabetes. It is not known whether fluocinonide topical will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant. It may not be safe to breastfeed while using fluocinonide. Ask your doctor about any risk. If you apply fluocinonide to your chest, avoid areas that may come into contact with the baby's mouth. Do not give fluocinonide to a child without medical advice. Some brands or forms of this medicine are not approved for use by anyone younger than 12 years old. Children can absorb larger amounts of fluocinonide through the skin and may be more likely to have side effects. How should I use fluocinonide topical? Use fluocinonide exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed. Do not take by mouth. Topical medicine is for use only on the skin. Do not use on open wounds or on sunburned, windburned, dry, or irritated skin. Rinse with water if this medicine gets in your eyes or mouth. Wash your hands before and after using fluocinonide, unless you are using this medicine to treat the skin on your hands. Apply a thin layer of medicine to the affected skin and rub it in gently. Do not apply fluocinonide over a large area of skin unless your doctor has told you to. Do not cover the treated skin area with a bandage or other covering unless your doctor tells you to. Covering treated areas can increase the amount of medicine absorbed through your skin and may cause harmful effects. If you are treating the diaper area, do not use plastic pants or tight-fitting diapers. If you are treating your scalp, part the hair and apply the medicine directly to the scalp, rubbing in gently. Avoid washing or rubbing the treated scalp area right away. Wait until the medicine has dried thoroughly. Call your doctor if your symptoms do not improve after 2 weeks of treatment, or if they get worse. If you need surgery, tell your surgeon you currently use this medicine. You should not stop using fluocinonide suddenly. Follow your doctor's instructions about tapering your dose. Store at room temperature away from moisture and heat. Do not freeze. Dosing information Usual Adult Dose for Dermatitis: 0.05% cream, gel, ointment: Apply a thin layer to affected area two to four times a day 0.1% cream: Apply a thin layer to affected area once or twice a day. Usual Adult Dose for Eczema: 0.05% cream, gel, ointment: Apply a thin layer to affected area two to four times a day 0.1% cream: Apply a thin layer to affected area once or twice a day. Usual Adult Dose for Atopic Dermatitis: 0.1% cream: Apply a thin layer to affected area once a day. Usual Adult Dose for Psoriasis: 0.1% cream: Apply a thin layer to affected area once or twice a day. Usual Pediatric Dose for Dermatitis: 12 years or older: 0.05% cream, gel, ointment: Apply a thin layer to affected area two to four times a day 0.1% cream: Apply a thin layer to affected area once or twice a day. Usual Pediatric Dose for Eczema: 12 years or older: 0.05% cream, gel, ointment: Apply a thin layer to affected area two to four times a day 0.1% cream: Apply a thin layer to affected area once or twice a day. Usual Pediatric Dose for Psoriasis: 12 years or older: 0.1% cream: Apply a thin layer to affected area once or twice a day. Usual Pediatric Dose for Atopic Dermatitis: 12 years or older: 0.1% cream: Apply a thin layer to affected area once a day.   What happens if I miss a dose? Apply the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not apply two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication. High doses or long-term use of fluocinonide topical can lead to thinning skin, easy bruising, changes in body fat (especially in your face, neck, back, and waist), increased acne or facial hair, menstrual problems, impotence, or loss of interest in sex. What should I avoid while using fluocinonide topical? Do not get fluocinonide topical in your eyes. If contact does occur, rinse with water. Avoid applying fluocinonide to your face, scalp, underarms, or groin area. Do not use fluocinonide topical to treat any skin condition that has not been checked by your doctor. Avoid using other topical steroid medications on the areas you treat with fluocinonide unless your doctor tells you to. Fluocinonide topical side effects Get emergency medical help if you have signs of an allergic reaction to fluocinonide: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have: redness, warmth, swelling, oozing, or severe irritation of any treated skin; worsening of your skin condition; or possible signs of absorbing fluocinonide through your skin - weight gain (especially in your face or your upper back and torso), slow wound healing, thinning or discolored skin, increased body hair, muscle weakness, nausea, diarrhea, tiredness, mood changes, menstrual changes, sexual changes. Steroid medicine can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using this medicine. Common fluocinonide side effects may include: burning, stinging, itching, or dryness of treated skin; redness or crusting around your hair follicles; stretch marks; spider veins; acne; lightened color of treated skin; headache; or stuffy nose, sore throat. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect fluocinonide topical? Medicine used on the skin is not likely to be affected by other drugs you use. But many drugs can interact with each other. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

What is mirtazapine? Mirtazapine is an antidepressant. The way this medication works is still not fully understood. It is thought to positively affect communication between nerve cells in the central nervous system and/or restore chemical balance in the brain. Mirtazapine is used to treat major depressive disorder in adults. It is not known if mirtazapine is safe and effective for use to treat MDD in children. Warnings You should not take mirtazapine if you are also taking tryptophan (sometimes called L-tryptophan). Do not use mirtazapine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine and others. Some people have thoughts about suicide when first taking an antidepressant. Your doctor will need to check your progress at regular visits while you are using mirtazapine. Your family or other caregivers should also be alert to changes in your mood or symptoms. Do not give this medicine to anyone younger than 18 years old without the advice of a doctor. This medicine is not approved for use in children. It may take up to several weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment. Drinking alcohol can increase certain side effects of mirtazapine. Mirtazapine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop taking this medicine abruptly. Talk to your doctor before stopping this medicine. Before taking this medicine You should not take this medicine if you are allergic to mirtazapine. Do not use mirtazapine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others. To make sure this medicine is safe for you, tell your doctor if you have ever had: low white blood cell counts; glaucoma; liver or kidney disease; low sodium levels in your blood; a seizure; depression, suicidal thoughts or actions; bipolar disorder (manic depression) in you or a family member; heart problems or stroke; high cholesterol or triglycerides; long QT syndrome (in you or a family member); or low blood pressure. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with mirtazapine and cause a serious condition called serotonin syndrome. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Tell your doctor if you are pregnant or breastfeeding. The orally disintegrating tablet may contain phenylalanine and could be harmful if you have phenylketonuria (PKU). Mirtazapine is not approved for use by anyone younger than 18 years old. How should I take mirtazapine? Take mirtazapine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Take the medicine at the same time each day, usually at bedtime. Take the regular tablet form of mirtazapine with water. You may take mirtazapine with or without food. Remove an orally disintegrating tablet from the package only when you are ready to take the medicine. Place the tablet on your tongue and allow it to dissolve, without chewing. Swallow several times as the tablet dissolves. It may take a few weeks for your symptoms to improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve after 4 weeks of treatment. Do not stop using mirtazapine suddenly, or you could have unpleasant symptoms (such as dizziness, vomiting, agitation, sweating, confusion, numbness, tingling, or electric shock feelings). Ask your doctor how to safely stop using this medicine. Store at room temperature away from moisture, heat, and light. Dosing information Usual Adult Dose for Depression: Initial dose: 15 mg orally once a day at bedtime Maintenance dose: 15 to 45 mg orally once a day Maximum dose: 45 mg/day Comments: -May increase the dose every 1 to 2 weeks to a maximum 45 mg/day according to patient response. -Patients should be periodically reassessed to determine the need for continued use of this drug. Use: Treatment of major depressive disorder Detailed Mirtazapine dosage information What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include confusion, memory problems, drowsiness, and fast heart rate. What to avoid Drinking alcohol with mirtazapine can cause side effects. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Mirtazapine side effects Get emergency medical help if you have signs of an allergic reaction to mirtazapine (hives, joint pain, fever, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: racing thoughts, decreased need for sleep, unusual risk-taking behavior, feelings of extreme happiness or sadness, being more talkative than usual; blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights; a light-headed feeling, like you might pass out; severe rash, blisters, or swelling on the palms of your hands or the soles of your feet; a seizure; low white blood cell counts - fever, chills, sore throat, cough, sores in your mouth or nose, flu-like symptoms, trouble breathing; or low sodium level - headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Common mirtazapine side effects include: drowsiness, dizziness; increased appetite; or weight gain. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect mirtazapine? Using mirtazapine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Tell your doctor about all your current medicines. Many drugs can affect mirtazapine, especially: cimetidine; diazepam; St. John's wort; tramadol; tryptophan (sometimes called L-tryptophan); an antibiotic - clarithromycin, rifampin, rifampicin, telithromycin; antifungal medicine - itraconazole, ketoconazole; antiviral medicine to treat HIV/AIDS - indinavir, nelfinavir, ritonavir, saquinavir; medicine to treat mood disorders, thought disorders, or mental illness - such as lithium, other antidepressants, or antipsychotics; migraine headache medicine - sumatriptan, rizatriptan, Imitrex, Maxalt, and others; or seizure medicine - carbamazepine, phenytoin. This list is not complete and many Other drugs may interact with mirtazapine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is nortriptyline? Nortriptyline is a tricyclic antidepressant. It affects chemicals in the brain that may be unbalanced in people with depression. Nortriptyline is used to treat symptoms of depression. Nortriptyline is not recommended for use in children. Warnings You should not use nortriptyline if you recently had a heart attack. Do not use nortriptyline if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine and others. Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Before taking this medicine You should not use nortriptyline if: you are allergic to it or similar medicines (amitriptyline, amoxapine, clomipramine, desipramine, doxepin, imipramine, protriptyline, trimipramine); you are allergic to certain seizure medications (carbamazepine, eslicarbazepine, oxcarbazepine, rufinamide); or you recently had a heart attack. Do not use nortriptyline if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others. Tell your doctor if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with nortriptyline could cause a serious condition called serotonin syndrome. Tell your doctor if you have used an "SSRI" antidepressant in the past 5 weeks, such as citalopram, escitalopram, fluoxetine (Prozac), fluvoxamine, paroxetine, sertraline (Zoloft), trazodone, or vilazodone. To make sure nortriptyline is safe for you, tell your doctor if you have ever had: unexplained fainting spells; a genetic heart condition called Brugada syndrome; a family history of unexplained death at younger than 45 years old; heart disease; a heart attack or stroke; a seizure; bipolar disorder (manic-depression); schizophrenia or other mental illness; a thyroid disorder; problems with urination; narrow-angle glaucoma; or if you are receiving electroshock treatment. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Tell your doctor if you are pregnant or breastfeeding. Nortriptyline is not approved for use by anyone younger than 18 years old. How should I take nortriptyline? Take nortriptyline exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). If you need surgery, tell your surgeon you currently use nortriptyline. You may need to stop for a short time. You may have unpleasant withdrawal symptoms if you stop using nortriptyline suddenly. Ask your doctor how to safely stop using this medicine. It may take a few weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use. Dosing information Usual Adult Dose for Depression: 25 mg orally 3 to 4 times per day -Maximum dose: 150 mg/day Comments: -The total daily dosage may be given once a day. -Patients should be started at lower doses, and the doses should be gradually increased. -When doses above 100 mg per day are given, plasma levels should be monitored and maintained in the optimum range of 50 to 150 ng/mL. Use: Relief of symptoms of depression Usual Geriatric Dose for Depression: 30 to 50 mg orally per day, in divided doses Comments: -The total daily dosage may be given once a day. -Patients should be started at lower doses, and the doses should be gradually increased. Use: Relief of symptoms of depression   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of nortriptyline can be fatal. Overdose symptoms may include irregular heartbeats, severe drowsiness, vision problems, confusion, hallucinations, agitation, stiff muscles, overactive reflexes, vomiting, feeling hot or cold, feeling like you might pass out, seizures, or coma. What to avoid Do not drink alcohol. Dangerous side effects or death could occur. Avoid driving or hazardous activity until you know how nortriptyline will affect you. Your reactions could be impaired. Nortriptyline could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Nortriptyline side effects Get emergency medical help if you have signs of an allergic reaction to nortriptyline: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights; restless muscle movements in your eyes, tongue, jaw, or neck; a light-headed feeling, like you might pass out; seizure (convulsions); new or worsening chest pain, pounding heartbeats or fluttering in your chest; sudden numbness or weakness, problems with vision, speech, or balance; fever, sore throat, easy bruising, unusual bleeding; painful or difficult urination; or jaundice (yellowing of the skin or eyes). Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Common nortriptyline side effects may include: increased blood pressure; numbness or tingling in your hands or feet; dry mouth, nausea, vomiting, loss of appetite; blurred vision; rash, itching; or breast swelling (in men or women). This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect nortriptyline? Using nortriptyline with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Tell your doctor about all your other medicines, especially: medicine to treat depression, anxiety, mood disorders, or mental illness; cold or allergy medicine (Benadryl, Sudafed, and others); a stimulant medicine, such as diet pills or ADHD medicine; medicine to treat Parkinson's disease; medicine to treat stomach problems, motion sickness, or irritable bowel syndrome; medicine to treat overactive bladder; or bronchodilator asthma medication. This list is not complete. Other drugs may interact with nortriptyline, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

What is paroxetine? Paroxetine is an antidepressant that belongs to group of drugs called selective serotonin reuptake inhibitors (SSRIs). Paroxetine affects chemicals in the brain that may be unbalanced in people with depression, anxiety, or other disorders. Paroxetine is used to treat depression, including major depressive disorder. Paroxetine is also used to treat panic disorder, obsessive-compulsive disorder (OCD), anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD)>. The Brisdelle brand of paroxetine is used to treat hot flashes related to menopause. Brisdelle is not for treating any other conditions. Warnings You should not use paroxetine if you are also taking pimozide or thioridazine. Do not use paroxetine within 14 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor Seek medical attention right away if you have symptoms such as: agitation, hallucinations, muscle stiffness, twitching, loss of coordination, dizziness, warmth or tingly feeling, nausea, vomiting, diarrhea, fever, sweating, tremors, racing heartbeats, or a seizure (convulsions). Do not stop using paroxetine without first asking your doctor. Before taking this medicine You should not use this medicine if you are allergic to paroxetine, or if you are also taking pimozide or thioridazine. Do not use an MAO inhibitor within 14 days before or 14 days after you take paroxetine. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. After you stop taking paroxetine you must wait at least 14 days before you start taking an MAO inhibitor. To make sure paroxetine is safe for you, tell your doctor if you have: heart disease, high blood pressure, or a stroke; liver or kidney disease; a bleeding or blood clotting disorder; seizures or epilepsy; bipolar disorder (manic depression), drug addiction, or suicidal thoughts; sexual problems; narrow-angle glaucoma; or low levels of sodium in your blood. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with paroxetine and cause a serious condition called serotonin syndrome. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine without your doctor's advice. Do not use Brisdelle if you are pregnant. You should not breastfeed while using this medicine. Paroxetine is not approved for use by anyone younger than 18 years old. How should I take paroxetine? Take paroxetine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Swallow the extended-release tablet whole and do not crush, chew, or break it. Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated. Do not stop using paroxetine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using paroxetine. Follow your doctor's instructions about tapering your dose. Store at room temperature away from moisture, heat, and light. Detailed Paroxetine dosage information What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of paroxetine can be fatal. What to avoid Avoid driving or hazardous activity until you know how paroxetine will affect you. Your reactions could be impaired. Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with paroxetine may cause you to bruise or bleed easily. Drinking alcohol with this medicine can cause side effects. Paroxetine side effects Get emergency medical help if you have signs of an allergic reaction to paroxetine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: racing thoughts, decreased need for sleep, unusual risk-taking behavior, feelings of extreme happiness or sadness, being more talkative than usual; blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights; unusual bone pain or tenderness, swelling or bruising; changes in weight or appetite; easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), coughing up blood; severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, fainting; or low levels of sodium in the body - headache, confusion, slurred speech, severe weakness, loss of coordination, feeling unsteady. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Common paroxetine side effects may include: vision changes; weakness, drowsiness, dizziness, tiredness; sweating, anxiety, shaking; sleep problems (insomnia); loss of appetite, nausea, vomiting, diarrhea, constipation; dry mouth, yawning; infection; headache; or decreased sex drive, impotence, abnormal ejaculation, or difficulty having an orgasm. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Paroxetine side effects (more detail) What other drugs will affect paroxetine? Using paroxetine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Tell your doctor about all your other medicines, especially: cimetidine (Tagamet), digoxin, St. John's wort, tamoxifen, theophylline, tryptophan (sometimes called L-tryptophan), warfarin (Coumadin, Jantoven); a diuretic or "water pill"; heart rhythm medicine; HIV or AIDS medications; certain medicines to treat narcolepsy or ADHD - amphetamine, atomoxetine, dextroamphetamine, Adderall, Dexedrine, Evekeo, Vyvanse, and others; narcotic pain medicine - fentanyl, tramadol; medicine to treat anxiety, mood disorders, thought disorders, or mental illness - such as buspirone, lithium, other antidepressants, or antipsychotics; migraine headache medicine - sumatriptan, rizatriptan, zolmitriptan, and others; or seizure medicine - phenobarbital, phenytoin. This list is not complete. Other drugs may interact with paroxetine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

What is paroxetine? Paroxetine is an antidepressant that belongs to group of drugs called selective serotonin reuptake inhibitors (SSRIs). Paroxetine affects chemicals in the brain that may be unbalanced in people with depression, anxiety, or other disorders. Paroxetine is used to treat depression, including major depressive disorder. Paroxetine is also used to treat panic disorder, obsessive-compulsive disorder (OCD), anxiety disorders, post-traumatic stress disorder (PTSD), and premenstrual dysphoric disorder (PMDD)>. The Brisdelle brand of paroxetine is used to treat hot flashes related to menopause. Brisdelle is not for treating any other conditions. Warnings You should not use paroxetine if you are also taking pimozide or thioridazine. Do not use paroxetine within 14 days before or 14 days after you have used an MAO inhibitor, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor Seek medical attention right away if you have symptoms such as: agitation, hallucinations, muscle stiffness, twitching, loss of coordination, dizziness, warmth or tingly feeling, nausea, vomiting, diarrhea, fever, sweating, tremors, racing heartbeats, or a seizure (convulsions). Do not stop using paroxetine without first asking your doctor. Before taking this medicine You should not use this medicine if you are allergic to paroxetine, or if you are also taking pimozide or thioridazine. Do not use an MAO inhibitor within 14 days before or 14 days after you take paroxetine. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, and tranylcypromine. After you stop taking paroxetine you must wait at least 14 days before you start taking an MAO inhibitor. To make sure paroxetine is safe for you, tell your doctor if you have: heart disease, high blood pressure, or a stroke; liver or kidney disease; a bleeding or blood clotting disorder; seizures or epilepsy; bipolar disorder (manic depression), drug addiction, or suicidal thoughts; sexual problems; narrow-angle glaucoma; or low levels of sodium in your blood. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. These medicines may interact with paroxetine and cause a serious condition called serotonin syndrome. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Taking an SSRI antidepressant during pregnancy may cause serious lung problems or other complications in the baby. However, you may have a relapse of depression if you stop taking your antidepressant. Tell your doctor right away if you become pregnant. Do not start or stop taking this medicine without your doctor's advice. Do not use Brisdelle if you are pregnant. You should not breastfeed while using this medicine. Paroxetine is not approved for use by anyone younger than 18 years old. How should I take paroxetine? Take paroxetine exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Swallow the extended-release tablet whole and do not crush, chew, or break it. Shake the oral suspension (liquid) before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). It may take up to 4 weeks before your symptoms improve. Keep using the medication as directed and tell your doctor if your symptoms do not improve. Tell your doctor if you have any changes in sexual function, such as loss of interest in sex, trouble having an orgasm, or (in men) problems with erections or ejaculation. Some sexual problems can be treated. Do not stop using paroxetine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using paroxetine. Follow your doctor's instructions about tapering your dose. Store at room temperature away from moisture, heat, and light.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of paroxetine can be fatal. What to avoid Avoid driving or hazardous activity until you know how paroxetine will affect you. Your reactions could be impaired. Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib (Celebrex), diclofenac, indomethacin, meloxicam, and others. Using an NSAID with paroxetine may cause you to bruise or bleed easily. Drinking alcohol with this medicine can cause side effects. Paroxetine side effects Get emergency medical help if you have signs of an allergic reaction to paroxetine (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling). Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: racing thoughts, decreased need for sleep, unusual risk-taking behavior, feelings of extreme happiness or sadness, being more talkative than usual; blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights; unusual bone pain or tenderness, swelling or bruising; changes in weight or appetite; easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), coughing up blood; severe nervous system reaction - very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, fainting; or low levels of sodium in the body - headache, confusion, slurred speech, severe weakness, loss of coordination, feeling unsteady. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Common paroxetine side effects may include: vision changes; weakness, drowsiness, dizziness, tiredness; sweating, anxiety, shaking; sleep problems (insomnia); loss of appetite, nausea, vomiting, diarrhea, constipation; dry mouth, yawning; infection; headache; or decreased sex drive, impotence, abnormal ejaculation, or difficulty having an orgasm. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect paroxetine? Using paroxetine with other drugs that make you drowsy can worsen this effect. Ask your doctor before using opioid medication, a sleeping pill, a muscle relaxer, or medicine for anxiety or seizures. Tell your doctor about all your other medicines, especially: cimetidine (Tagamet), digoxin, St. John's wort, tamoxifen, theophylline, tryptophan (sometimes called L-tryptophan), warfarin (Coumadin, Jantoven); a diuretic or "water pill"; heart rhythm medicine; HIV or AIDS medications; certain medicines to treat narcolepsy or ADHD - amphetamine, atomoxetine, dextroamphetamine, Adderall, Dexedrine, Evekeo, Vyvanse, and others; narcotic pain medicine - fentanyl, tramadol; medicine to treat anxiety, mood disorders, thought disorders, or mental illness - such as buspirone, lithium, other antidepressants, or antipsychotics; migraine headache medicine - sumatriptan, rizatriptan, zolmitriptan, and others; or seizure medicine - phenobarbital, phenytoin. This list is not complete. Other drugs may interact with paroxetine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

What is phenelzine? Phenelzine is a monoamine oxidase inhibitor (MAOI) that is used to treat symptoms of atypical depression in adults when other medicines have not been effective. Phenelzine is not for treating severe depression or bipolar disorder (manic depression). Phenelzine may also be used for purposes not listed in this medication guide. Warnings Some young people have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. There are many other drugs, foods, and beverages that can cause dangerously high blood pressure if you take them together with phenelzine. Tell your doctor about all your current medicines and any you start or stop using. Avoid drinking alcohol, and learn about the foods you should avoid. Symptoms of dangerously high blood pressure include: a sudden and severe headache, nausea, vomiting, fever, cold sweat, dilated pupils, light sensitivity, fast or pounding heartbeats, neck stiffness, weakness, or problems with vision or speech. Before taking this medicine You should not use phenelzine if you are allergic to it, or if you have: pheochromocytoma (tumor of the adrenal gland). congestive heart failure; severe kidney disease; or a history of liver problems or abnormal liver function tests. A dangerous drug interaction can occur between phenelzine and certain other medicines you use within 14 days before or after taking phenelzine. Your doctor may change your treatment plan if you need to use any of these medicines, including: epinephrine or norepinephrine; bupropion, buspirone, carbamazepine, guanethidine, levodopa, meperidine, methyldopa, tryptophan; ADHD medication; diet pills, cough and cold or allergy medicines; opioid medicine; other antidepressants; another MAO inhibitor--furazolidone, isocarboxazid, linezolid, methylene blue injection, procarbazine, rasagiline, selegiline, tranylcypromine, and others; or drugs that affect serotonin levels in your body--stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. This is not a complete list and there may be other medicines you should not take while you are taking phenelzine. Tell your doctor if you have ever had: high blood pressure, heart disease; diabetes; schizophrenia; epilepsy or other seizure disorder; or if you have taken another antidepressant within the past 5 weeks. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Tell your doctor if you are pregnant or breastfeeding. Phenelzine is not approved for use by anyone younger than 18 years old. How should I take phenelzine? Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed. Your blood pressure will need to be checked often. You may need to stop using phenelzine for a short time before any type of surgery or medical procedure. Tell any doctor who treats you that you take phenelzine. It may take a few weeks before you receive the full benefit of taking phenelzine. Your doctor will determine how long to treat you with phenelzine. Do not stop using phenelzine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine. Store at room temperature away from moisture and heat. What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include feeling drowsy or dizzy, severe headache, neck pain or stiffness, hallucinations, shallow breathing, fast and uneven heart rate, cold sweats, feeling like you might pass out, or seizure (convulsions). What should I avoid while taking phenelzine? Do not drink alcohol. Dangerous side effects could occur. You must not eat certain foods, including: air dried, aged, smoked, or fermented meats, including sausage, pepperoni, Lebanon bologna, or salami; beer, wine, reduced-alcohol or alcohol-free beer or wine; pickled herring; aged cheeses, including blue, boursault, brie, camembert, cheddar, gruyere, mozzarella, parmesan, Romano, Roquefort, and Swiss; moldy or improperly stored meat, fish, poultry, or liver; soy sauce, miso soup, bean curd, fava beans; sauerkraut; yogurt; yeast extracts, Marmite; or excessive amounts of chocolate or caffeine. Eating these foods while you are taking phenelzine can raise your blood pressure to dangerous levels, causing life-threatening side effects. Also avoid these foods for 2 weeks after you stop taking phenelzine. Phenelzine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Phenelzine side effects Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: sudden and severe headache, neck pain or stiffness; pounding heartbeats or fluttering in your chest; fast or slow heartbeats; chest pain; a light-headed feeling, like you might pass out; sweating (sometimes with fever and sometimes with cold, clammy skin); nausea, vomiting; or dilated pupils (your eyes may be more sensitive to light). Common side effects may include: dizziness, feeling light-headed; drowsiness, sleep problems; headache; feeling weak or tired; tremors, muscle twitching; dry mouth, stomach discomfort, constipation; swelling, weight gain; or sexual problems. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   Phenelzine dosing information Usual Adult Dose for Depression: Early phase treatment: -Initial dose: 15 mg orally 3 times a day -Dose titration: Increase to at least 60 mg per day fairly rapidly, as tolerated -Maximum dose: 90 mg/day Maintenance: -Maintenance dose may be as low as 15 mg orally once a day or 15 mg orally every other day -Duration of therapy: As long as required Comments: -This drug should rarely be the first antidepressant used; it is more suitable for patients unresponsive to more commonly used medications. -This drug is effective in depressed patients characterized as atypical, nonendogenous, or neurotic, who often have mixed anxiety and depression and phobic or hypochondriacal features. -Evidence of usefulness in severely depressed patients with endogenous features is less conclusive. -Clinical response may not be seen until at least 4 weeks at 60 mg per day dosing -After maximal benefit is achieved, reduce dose slowly over several weeks. Use: Treatment of clinically characterized atypical, nonendogenous, or neurotic depression, especially in patients who have failed first-line treatments   What other drugs will affect phenelzine? When you start or stop taking phenelzine, your doctor may need to adjust the doses of any other medicines you take on a regular basis. There are many other drugs that can cause serious medical problems if you take them together with phenelzine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is sertraline? Sertraline is an antidepressant that belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Sertraline affects chemicals in the brain that may be unbalanced in people with depression, panic, anxiety, or obsessive-compulsive symptoms. Sertraline is used to treat major depressive disorder, obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD). Sertraline is also used to treat premenstrual dysphoric disorder. Warnings You should not use sertraline if you also take pimozide, or if you are being treated with methylene blue injection. Do not use sertraline if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. Some children and young adults have thoughts about suicide when first taking an antidepressant. Stay alert to changes in your mood or symptoms. Report any new or worsening symptoms to your doctor. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Before taking this medicine You should not use sertraline if you are allergic to it, or if you also take pimozide. Do not use the liquid form of this medicine if you take disulfiram (Antabuse). Do not use sertraline within 14 days before or 14 days after using an MAO inhibitor. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others. Tell your doctor if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with sertraline could cause a serious condition called serotonin syndrome. To make sure sertraline is safe for you, tell your doctor if you have ever had: bipolar disorder (manic depression); heart disease, high blood pressure, or a stroke; liver or kidney disease; seizures; glaucoma; bleeding problems, or if you take warfarin (Coumadin, Jantoven); long QT syndrome; or low levels of sodium in your blood. Some young people have thoughts about suicide when first taking an antidepressant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms. Sertraline is approved for use in children at least 6 years old, only to treat obsessive-compulsive disorder but not depression. Taking sertraline during pregnancy could harm the baby, but stopping the medicine may not be safe for you. Do not start or stop this medicine without asking your doctor. Ask a doctor if it is safe to breastfeed while using this medicine. How should I take sertraline? Take sertraline exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Take sertraline with or without food, at the same time each day. Sertraline liquid (oral concentrate) must be diluted with a liquid right before you take it. Read and carefully follow all mixing instructions provided with your medicine. Ask your doctor or pharmacist if you need help. Measure the mixed medicine with the supplied syringe or a dose-measuring device (not a kitchen spoon). Sertraline may cause false results on a drug-screening urine test. Tell the laboratory staff that you use this medicine. Do not stop using sertraline suddenly, or you could have unpleasant symptoms (such as agitation, confusion, tingling or electric shock feelings). Ask your doctor before stopping the medicine. Store tightly closed at room temperature, away from moisture and heat. Dosing information Usual Adult Dose for Depression: Initial dose: 50 mg orally once a day Maintenance Dose: 50 to 200 mg orally once a day. Usual Adult Dose for Obsessive Compulsive Disorder: Initial dose: 50 mg orally once a day Maintenance Dose: 50 to 200 mg orally once a day Usual Adult Dose for Panic Disorder: Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day Maintenance dose: 50 to 200 mg orally once a day. Usual Adult Dose for Post Traumatic Stress Disorder: Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day Maintenance dose: 50 to 200 mg orally once a day Usual Adult Dose for Social Anxiety Disorder: Initial dose: 25 mg orally once a day, increased after one week to 50 mg orally once a day Maintenance dose: 50 to 200 mg orally once a day. Usual Adult Dose for Premenstrual Dysphoric Disorder: Continuous regimen: -Initial dose: 50 mg orally once a day during the menstrual cycle -Maintenance dose: 50 to 150 mg orally once a day during the menstrual cycle Cyclic regimen: -Initial dose: 50 mg orally once a day starting 14 days prior to the anticipated start of menstruation through to the first full day of menses, and repeated with each new cycle -Maintenance dose: 50 to 100 mg orally once a day. Usual Pediatric Dose for Obsessive Compulsive Disorder: 6 to 12 years: -Initial dose: 25 mg orally once a day -Maintenance dose: 25 to 200 mg orally once a day 13 to 17 years: -Initial dose: 50 mg orally once a day -Maintenance dose: 50 to 200 mg orally once a day.   What happens if I miss a dose? Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. What should I avoid while taking sertraline? Drinking alcohol with sertraline can cause side effects. Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired. Sertraline side effects Get emergency medical help if you have signs of an allergic reaction to sertraline: skin rash or hives (with or without fever or joint pain); difficulty breathing; swelling of your face, lips, tongue, or throat. Report any new or worsening symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself. Call your doctor at once if you have: a seizure; vision changes, eye pain, redness, or swelling; low blood sodium - headache, confusion, problems with thinking or memory, weakness, feeling unsteady; or manic episodes - racing thoughts, increased energy, unusual risk-taking behavior, extreme happiness, being irritable or talkative. Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea. Sertraline can affect growth in children. Your child's height and weight may be checked often. Common sertraline side effects may include: indigestion, nausea, diarrhea, loss of appetite; sweating; tremors; or sexual problems. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.   What other drugs will affect sertraline? Sertraline can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV. Ask your doctor before taking a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin, ibuprofen, naproxen, Advil, Aleve, Motrin, and others. Using an NSAID with sertraline may cause you to bruise or bleed easily. Other drugs may interact with sertraline, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.