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Consideration should be given to changing the therapeutic regimenincluding possibly discontinuing the medicationin patients whose depression is persistently worseor who are experiencing emergent suicidality or symptoms that might be precursors to worsening depression or suicidalityespecially if these symptoms are severeabrupt in onsetor were not part of the patient’s presenting symptoms.
Antidepressants have been associated with cases of clinically significant hyponatremia in elderly patients who may be at greater risk for this adverse reaction.
It is important to continue taking this medication as prescribed even if you feel wellTo help you remembertake it at the same time(seach dayDo not stop taking this medication without consulting your doctorAnxietyagitationand trouble sleeping can occur if the drug is suddenly stopped.
Before using this medicationtell your doctor or pharmacist your medical historyespecially ofpersonal or family history of bipolar disorderpersonal or family history of suicide attemptsheart diseasee.girregular heartbeatheart attackliver diseasekidney diseaseblood pressure problemspersonal or family history of glaucomaangle-closure type
Report any new or worsening symptoms to your doctorsuch asmood or behavior changesanxietypanic attackstrouble sleepingor if you feel impulsiveirritableagitatedhostileaggressiverestlesshyperactivementally or physicallymore depressedor have thoughts about suicide or hurting yourself.
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