Usual Adult Dose for Depression

Initial dose: 150 mg orally per day in divided doses; this may be increased by 50 mg orally per day every 3 to 4 days
Maximum dose:

• Inpatients: 600 mg/day
• Outpatients: 400 mg/day

• Patients should be screened for a personal/family history of bipolar disorder, mania, or hypomania prior to initiating treatment.
• Patients should be monitored for withdrawal symptoms when discontinuing therapy.
• After an adequate response has been reached, dosage may be gradually reduced depending on therapeutic response.
• If drowsiness develops, a major portion of the daily dose may be administered at bedtime or a reduction of dosage may be necessary.
• This drug should be taken shortly after a meal or light snack.

Renal Dose Adjustments

Use with caution.

Liver Dose Adjustments

Use with caution.

Dose Adjustments

Switching to/from a MAOI:

• From a MAOI used to treat psychiatric disorders: Allow at least 14 days before beginning this drug.
• To a MAOI used to treat psychiatric disorders: Allow at least 14 days after stopping this drug before beginning treatment with the MAOI.
• Use with linezolid or IV methylene blue: If treatment is absolutely necessary, promptly discontinue treatment with this drug.

• Strong CYP450 3A4 inducers: Providers should consider increasing the dose of this drug based on tolerability and therapeutic response.
• Strong CYP450 3A4 inhibitors: Providers should consider decreasing the dose of this drug based on tolerability and therapeutic response.

• A gradual dose reduction is recommended instead of abrupt cessation where possible.

Precautions

US BOXED WARNINGS:
SUICIDAL THOUGHTS AND BEHAVIORS:

• Antidepressants increased the risk of suicidal thoughts and behaviors in pediatric and young adult patients in short-term studies.
• Closely monitor all antidepressant-treated patients for clinical worsening and emergence of suicidal thoughts and behaviors.
• This drug is not approved for use in pediatric patients.

Dialysis

Data not available

Other Comments

Administration advice:

• Tablets can be swallowed whole or administered as a half tablet by breaking the tablet along the score line.
• Tablets should not be chewed or crushed.
• Tolerability may be improved by taking the drug after a meal.

• Oral solutions should not be mixed with other products.

• Cardiovascular: Orthostatic vital signs in at-risk patients
• Metabolic: Monitor for increases in blood sugar, weight, and lipids; monitor electrolytes and fluids in patients with symptomatic hyponatremia
• Nervous system: Monitor for serotonin syndrome
• Psychiatric: Patients should be monitored for worsening and emergence of suicidal thoughts.

• This drug may impair judgment, thinking, or motor skills; have patient avoid driving or operating machinery until adverse effects are determined.
• Advise patients to speak to physician or health care professional if they are pregnant, intend to become pregnant, or are breastfeeding.
• Patients should be informed of the possibility of priapism, hyponatremia, neuroleptic malignant syndrome, and tardive dyskinesia, and what to do if symptoms occur.
• Patients, families, and caregivers should be educated on the risks of suicidal thoughts and behaviors, as well as the risk of mania and hypomania; what to watch for and when to seek medical advice.

Frequently asked questions

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