2.1 Recommended Dosage

Administer CELEXA once daily, with or without food, at an initial dosage of 20 mg once daily, with an increase to a maximum dosage of 40 mg once daily at an interval of no less than one week.

Dosages above 40 mg once daily are not recommended due to the risk of QT prolongation [see Warnings and Precautions (5.2)].

2.2 Screen for Bipolar Disorder Prior to Starting CELEXA

Prior to initiating treatment with CELEXA or another antidepressant, screen patients for a personal or family history of bipolar disorder, mania, or hypomania [See Warnings and Precautions (5.5)].

2.3 Recommended Dosage for Specific Populations

The maximum recommended dosage of CELEXA for patients who are greater than 60 years of age, patients with hepatic impairment, and for CYP2C19 poor metabolizers is 20 mg once daily [see Warnings and Precautions (5.2), Clinical Pharmacology (12.3)].

2.4 Dosage Modifications with Concomitant Use of CYP2C19 Inhibitors

The maxium recommended dosage of CELEXA when used concomitantly with a CYP2C19 inhibitor is 20 mg once daily [see Warnings and Precautions (5.2), Drug Interactions (7)].

2.5 Switching Patients to or from a Monoamine Oxidase Inhibitor Antidepressant

At least 14 days must elapse between discontinuation of a monoamine oxidase inhibitor (MAOI) antidepressant and initiation of therapy with CELEXA. Conversely, at least 14 days must elapse after stopping CELEXA before starting an MAOI antidepressant [see Contraindications (4) and Warnings and Precautions (5.3)].

2.6 Discontinuing Treatment with CELEXA

Adverse reactions may occur upon discontinuation of CELEXA [see Warnings and Precautions (5.6)]. Gradually reduce the dosage rather than stopping CELEXA abruptly whenever possible.