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Pliszka S July 2007

Ascher JA, Cole JO, Colin JN et al. September 1995. "Bupropion: a review of its mechanism of antidepressant activity". J Clin Psychiatry. Postural hypotension, hypertension, stroke, vasodilation, syncope, complete atrioventricular block, extrasystoles, myocardial infarction, phlebitis, and pulmonary embolism. Never stop an antidepressant medicine without first talking to a healthcare provider. Stopping an antidepressant medicine suddenly can cause other symptoms. What are Bupropion hydrochloride extended-release tablets XL? buy phenazopyridine online mastercard uk phenazopyridine

Stenson, Jacqueline 12 October 2007

Carbamazepine, Phenobarbital, Phenytoin: While not systematically studied, these drugs may induce the metabolism of Bupropion. With proper help, many people lose weight after they stop bingeing. Keep Bupropion hydrochloride extended-release tablets XL and all medicines out of the reach of children. It is generally agreed that acute episodes of depression require several months or longer of antidepressant treatment beyond the response in the acute episode. It is unknown whether the Bupropion hydrochloride extended-release tablets XL dose needed for maintenance treatment is identical to the dose that provided an initial response. Periodically reassess the need for maintenance treatment and the appropriate dose for such treatment.

Before taking bupropion

Review of the Neuropharmacology of Bupropion, a Dual Norepinephrine and Dopamine Reuptake Inhibitor”. Ncbi. Retrieved 2011-10-31. Studies in rodents and primates demonstrated that Bupropion exhibits some pharmacologic actions common to psychostimulants. In rodents, it has been shown to increase locomotor activity, elicit a mild stereotyped behavioral response, and increase rates of responding in several schedule-controlled behavior paradigms. In primate models assessing the positive reinforcing effects of psychoactive drugs, Bupropion was self-administered intravenously. In rats, Bupropion produced amphetamine-like and cocaine-like discriminative stimulus effects in drug discrimination paradigms used to characterize the subjective effects of psychoactive drugs.

Bupropion overdose

Warning: The facts and figures contained in these reports are accurate to the best of our capability; however, our metrics are only meant to augment your medical knowledge, and should never be used as the sole basis for selecting a new medication. As with any medical decision, be sure to work with your doctor to ensure the best choices are made for your condition. Children, teenagers, and young adults who take antidepressants to treat depression or other mental illnesses may be more likely to become suicidal than children, teenagers, and young adults who do not take antidepressants to treat these conditions. This risk should be considered and compared with the potential benefit in the treatment of depression, in deciding whether a child or teenager should take an antidepressant. Children younger than 18 years of age should not normally take bupropion, but in some cases, a doctor may decide that bupropion is the best medication to treat a child's condition.



Bupropion brand names

Before having surgery, tell your doctor or dentist about all the products you use including prescription drugs, nonprescription drugs, and herbal products. Many of these medications come in both short- and long-acting forms. Short-acting drugs wear off after about 4 hours. You take them two times a day. Long-acting drugs can last 8 to 12 hours, and you take them once a day. Talk with your doctor to decide which works best for your life, and to figure out the best time of day to take your medication. Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first. Aplenzin: In patients receiving 348 mg once daily, taper dose down to 174 mg once daily for 2 weeks prior to discontinuing. Suicidal behavior is less of a concern when bupropion is prescribed for smoking cessation. Trials 1, 2 and 3, respectively. CYP2B6 Inhibitors Weak: May increase the serum concentration of BuPROPion. Exceptions: Prasugrel. Many people binge because it makes them feel less stressed, at least in the short term. Metoprolol: CYP2D6 Inhibitors may increase the serum concentration of Metoprolol. Management: Consider an alternative for one of the interacting drugs in order to avoid metoprolol toxicity. If the combination must be used, monitor response to metoprolol closely. Metoprolol dose reductions may be necessary. See SSRIs and NRIs.



What are the possible side effects of bupropion

This information is generalized and not intended as specific medical advice. Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? Be sure to mention any of the following: amantadine Symmetrel; beta blockers such as atenolol Tenormin labetalol Normodyne metoprolol Lopressor, Toprol XL nadolol Corgard and propranolol Inderal; cimetidine Tagamet; clopidogrel Plavix; cyclophosphamide Cytoxan, Neosar; efavirenz Sustiva, in Atripla; insulin or oral medications for diabetes; medications for irregular heartbeat such as flecainide Tambocor and propafenone Rythmol; medications for mental illness such as haloperidol Haldol risperidone Risperdal and thioridazine Mellaril; medications for seizures such as carbamazepine Tegretol phenobarbital Luminal, Solfoton and phenytoin Dilantin; levodopa Sinemet, Larodopa; lopinavir and ritonavir Kaletra; nelfinavir Viracept; nicotine patch; oral steroids such as dexamethasone Decadron, Dexone methylprednisolone Medrol and prednisone Deltasone; orphenadrine Norflex; other antidepressants such as citalopram Celexa desipramine Norpramin fluoxetine Prozac, Sarafem, in Symbyax fluvoxamine Luvox imipramine Tofranil nortriptyline Aventyl, Pamelor paroxetine Paxil and sertraline Zoloft; ritonavir Norvir; sedatives; sleeping pills; tamoxifen Nolvadex, Soltamox; theophylline Theobid, Theo-Dur, others; thiotepa; and ticlopidine Ticlid. Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Retrieved 13 October 2007. Dosing conversion between hydrochloride salt immediate Wellbutrin sustained Wellbutrin SR and extended release Wellbutrin XL, Forfivo XL products: Convert using same total daily dose up to the maximum recommended dose for a given dosage form but adjust frequency as indicated for sustained twice daily or extended once daily release products. Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Rossi, S, ed. 2013. Sexual dysfunction: The incidence of sexual dysfunction with bupropion is generally lower than with SSRIs. Discontinue Bupropion hydrochloride extended-release tablets XL if these reactions occur. Keep Bupropion hydrochloride extended-release tablets XL dry and out of light. antabuse



How to take bupropion

Arnold 2000. “Methylphenidate vs Amphetamine: Comparative Review”. On 11 October 2007, two providers of consumer information on nutritional products and supplements, and The People's Pharmacy, released the results of comparative tests of different brands of bupropion. The People's Pharmacy received multiple reports of increased side effects and decreased efficacy of generic bupropion, which prompted it to ask ConsumerLab. May precipitate a manic, mixed, or hypomanic episode; risk is increased in patients with bipolar disorder or who have risk factors for bipolar disorder. Screen patients for a history of bipolar disorder and the presence of risk factors including a family history of bipolar disorder, suicide, or depression. Bupropion is not FDA approved for bipolar depression. No suicides occurred in any of the pediatric trials. There were suicides in the adult trials, but the number was not sufficient to reach any conclusion about drug effect on suicide. MiFEPRIStone: May increase the serum concentration of CYP2B6 Substrates. Yes, you are correct. Bupropion Wellbutrin is not an SSRI and is structurally very different than any typical anti-depressant. It is an aminoketone, as you stated, and resembles a phenythlamine; more specifically, it resembles a cathinone. It does not act on serotonin whatsoever and is a unique drug due to its action as an NDRI and a nicotinic antagonist. The latter is why it is prescribed for smoking cessation. Bupropion is extensively metabolized in humans. Three metabolites are active: hydroxyBupropion, which is formed via hydroxylation of the tert-butyl group of Bupropion, and the amino-alcohol isomers threohydroBupropion and erythrohydroBupropion, which are formed via reduction of the carbonyl group. In vitro findings suggest that CYP2B6 is the principal isoenzyme involved in the formation of hydroxyBupropion, while cytochrome P450 enzymes are not involved in the formation of threohydroBupropion. Oxidation of the Bupropion side chain results in the formation of a glycine conjugate of meta-chlorobenzoic acid, which is then excreted as the major urinary metabolite. The potency and toxicity of the metabolites relative to Bupropion have not been fully characterized. However, it has been demonstrated in an antidepressant screening test in mice that hydroxyBupropion is one half as potent as Bupropion, while threohydroBupropion and erythrohydroBupropion are 5-fold less potent than Bupropion. This may be of clinical importance, because the plasma concentrations of the metabolites are as high or higher than those of Bupropion. It's interesting because someone earlier mentioned becoming almost obsessed with taking more. I've noticed this too. It's clearly got dopaminergic properties since dopamine mediates craving. At first I wouldn't notice anything, but as time has gone on I have developed a definite 'liking'. It's the strangest thing. I would characterize the initial feeling as a mild euphoria, that builds to a general warmth. Mood is enhanced but due to the stimulant nature of bupropion, I notice that my anxiety tends to skyrocket. But I do enjoy the physical sensation of insufflated bupropion. Haha dude I know the feeling. Journal of American College Health, Vol. 53, No. 4 2005. According to surveys, the addition to a prescribed SSRI is a common strategy when people do not respond to the SSRI, even though this is not an officially approved indication. The addition of bupropion to an SSRI most commonly fluoxetine or sertraline may result in an improvement in some people who have an incomplete response to the first-line antidepressant. Citalopram: Citalopram did not affect the pharmacokinetics of Bupropion and its three metabolites. The FDA investigated these complaints and concluded that Budeprion XL is equivalent to Wellbutrin XL in regard to bioavailability of bupropion and its main active metabolite hydroxybupropion.



Prescribing information for bupropion

Nemeroff CB, Schatzberg AF 2006. Essentials of clinical psychopharmacology. Also, they have to have been doing this for at least 6 months. You may have nicotine withdrawal symptoms when you stop smoking, including: increased appetite, weight gain, trouble sleeping, trouble concentrating, slower heart rate, having the urge to smoke, and feeling anxious, restless, depressed, angry, frustrated, or irritated. These symptoms may occur with or without using medication such as Zyban. Nilotinib: May decrease the serum concentration of CYP2B6 Substrates. In postmarketing experience, there have been rare reports of adverse neuropsychiatric events or reduced alcohol tolerance in patients who were drinking alcohol during treatment with Bupropion hydrochloride extended-release tablets XL. The consumption of alcohol during treatment with Bupropion hydrochloride extended-release tablets XL should be minimized or avoided. Fava M, Rush AJ, Thase ME, et al. 2005. Report of the Adderall XR New Drug Committee”. Health Canada. 2005-08-26. Retrieved 2009-06-23. Store at room temperature away from light and moisture. tablets may have a strange odor. This is normal, and the is still safe to use. not store in the bathroom. Keep all away from children and pets. The dosage is based on your medical condition, liver function, and response to treatment. To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase. The next most common use is as an aid for smoking cessation. Bupropion reduces the severity of cravings and symptoms. Bupropion is helpful for smoking cessation in smokers with no history of depression; thus, the effectiveness of bupropion is not due to its antidepressant effect. A typical bupropion treatment course lasts up to twelve weeks, with the people halting the use of tobacco about ten days into the course. Bupropion approximately doubles the chance of quitting smoking successfully. Oppek K, Koller G, Zwergal A, Pogarell O June 2014. "Intravenous Administration and Abuse of Bupropion: A Case Report and a Review of the Literature". J Addict Med. Alan F. Schatzberg, Charles B. Nemeroff. 2004. Schatzberg, Alan F; Nemeroff, Charles B. eds. No stimulant has been proven to work better than others. Each child responds differently to these medicines. Drinking alcohol with bupropion may increase your risk of seizures. If you drink alcohol regularly, talk with your doctor before changing the amount you drink. Bupropion can also cause seizures in a regular drinker who suddenly stops drinking at the start of treatment with bupropion. toradol price in usa



Bupropion dosage

XL was that there was no significant difference in the rate and extent of absorption as measured by the plasma bupropion concentrations between 150 mg of the Teva XL product and 150 mg of Wellbutrin XL. Because of the potential risk of seizures at higher doses, the 300 mg strength was not studied. What is the most important information I should know about antidepressant medicines, depression and other serious mental illnesses, and suicidal thoughts or actions? Multiple oral doses of Bupropion had no statistically significant effects on the single-dose pharmacokinetics of lamotrigine in 12 healthy volunteers. PDF. United States Food and Drug Administration. 10 September 2014. Take Bupropion hydrochloride extended-release tablets XL at the same time each day.



How should i store bupropion

Zyvox and serotonergic psychiatric medications. But I enjoy that initial wave of energy that lasts a minute or so and then gives way to the warmth. So I want to do more. Thank God my nose clogged up. The craziest part is, I really wonder if this is all placebo effect. South Korea: Non-prescribed Amphetamine-based medications are banned in South Korea. Arias HR, Santamaría A, Ali SF 2009. "Pharmacological and neurotoxicological actions mediated by bupropion and diethylpropion". Int. Rev. Neurobiol. Parents and pediatricians should watch carefully for side effects from medicine. discount mycelex medication



Kampman KM June 2008

Data from epidemiological studies including pregnant women exposed to Bupropion in the first trimester indicate no increased risk of congenital malformations overall. All pregnancies regardless of drug exposure have a background rate of 2% to 4% for major malformations and 15% to 20% for pregnancy loss. No clear evidence of teratogenic activity was found in reproductive developmental studies conducted in rats and rabbits. However, in rabbits, slightly increased incidences of fetal malformations and skeletal variations were observed at doses approximately equal to the maximum recommended human dose MRHD and greater and decreased fetal weights were seen at doses twice the MRHD and greater. Bupropion hydrochloride extended-release tablets XL should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Patients should be advised that taking Bupropion hydrochloride extended-release tablets XL can cause mild pupillary dilation, which in susceptible individuals, can lead to an episode of angle-closure glaucoma. Pre-existing glaucoma is almost always open-angle glaucoma because angle-closure glaucoma, when diagnosed, can be treated definitively with iridectomy. Open-angle-glaucoma is not a risk factor for angle-closure glaucoma. Baldwin DS, Papakostas GI 2006. "Symptoms of fatigue and sleepiness in major depressive disorder". J Clin Psychiatry. Retrieved 15 June 2015. Researchers have also found links between ADHD and the use of and other recreational drugs, particularly in people who also have other psychological disorders such as obsessive-compulsive disorder. What's more, people with ADHD typically start having problems with drugs and alcohol at an earlier age than people without the condition. Bupropion hydrochloride extended-release tablets XL should be swallowed whole and not crushed, divided, or chewed. Bupropion hydrochloride extended-release tablets XL should be administered in the morning and may be taken with or without food. Pisani F, Oteri G, Costa C, Di Raimondo G, Di Perri R 2002. "Effects of psychotropic drugs on seizure threshold". Drug Saf. Parents sometimes worry whether the stimulant drugs their children are taking to treat ADHD such as and Adderall are themselves addictive. Some patients, children and adolescents, may show signs of increased aggression. Extended release: Administer once daily with at least 24 hours between successive doses. Take this medication by with or without food as directed by your doctor, usually once daily in the morning. If you have upset, you may take this medication with or after a meal or snack. Taking this medication late in the day may cause . Take this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Teva Budeprion 150 mg product or generic bupropion products made by other manufacturers. Do not snort this drug! Because Adderall may increase blood pressure, it carries the same risk of sudden death, stroke, and heart attack, as do methylphenidate and other stimulants used to treat ADHD, as well as the same risk of seizures in patients with a history of seizures. Consider the risk of untreated depression when discontinuing or changing treatment with antidepressant medications during pregnancy and postpartum. Retrieved 1 June 2017.



Retrieved 7 October 2006

Next, you put the equivalent of one pill into a spoon with about 50-60 units of water, and you crush the pieces down until they're all basically broken down. Then, you cook them in the spoon with a lighter or heat source, the same way you would heroin. Do not hold the heat so close to the spoon that it starts boiling, but just heat it up enough to dissolve the pieces, then put about 10-20 more units of water on it and mix it up a little bit. Lastly, use a cotton to draw up the liquid, if it is too thick then add some more water or suck up some water into the syringe to thin it out. Hydrochloride salt Forfivo XL: Switching from Wellbutrin immediate release, SR, or XL to Forfivo XL: Patients receiving 300 mg daily of bupropion hydrochloride for at least 2 weeks and requiring a dose increase or patients already taking 450 mg daily of bupropion hydrochloride may switch to Forfivo XL 450 mg once daily. Some people may have a particularly high risk of having suicidal thoughts or actions. These include people who have or have a family history of bipolar illness also called manic-depressive illness or suicidal thoughts or actions. Btw keep it up with the whole "reformed druggie" thing haha, it's fun to get fucked up, but it's also fun to live too. Welbutrin because of the depression that often follows quitting smoking. The first thing you need to know is that you HAVE to use Wellbutrin XL or bupropion HCL XL ONLY. You cannot use the SR version of the medication because it gels up. I have not tested other forms of the drug. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Always consult your doctor or healthcare specialist for medical advice. Alcohol can make the side effects from bupropion worse. Your doctor may need to monitor your pressure closely. Do not smoke at any time if using any nicotine products with this drug. Too much nicotine can cause serious side effects. An empty tablet shell may appear in your stool. This effect is harmless because your body has already absorbed the medication. Bupropion hydrochloride extended-release tablets XL stop taking the tablets and call your healthcare provider right away. Do not take Bupropion hydrochloride extended-release tablets XL again if you have a seizure. Dwoskin LP, Rauhut AS, King-Pospisil KA, Bardo MT 2006. "Review of the pharmacology and clinical profile of bupropion, an antidepressant and tobacco use cessation agent". CNS Drug Rev. Immediate release: Administer 3 to 4 times daily with at least 6 hours between successive doses; do not exceed 150 mg in a single dose. Cognitive impairment: May cause motor or cognitive impairment in some patients, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness eg, operating machinery or driving. It should be avoided in individuals who are also taking MAOIs. When switching from MAOIs to bupropion, it is important to include a washout period of about two weeks between the medications. clozapine



What other drugs will affect bupropion

Bupropion through human milk. Food and Drug Administration. LVOTO as above. The NBDPS and United Healthcare database study did not find an association between first trimester maternal Bupropion exposure and VSD. Sustained release: Administer 2 times daily with at least 8 hours between successive doses. Tyndale RF. CYP2B6 and bupropion's smoking-cessation pharmacology: the role of hydroxybupropion. Bupropion was granted a licence for use in adults with major depression in the Netherlands in early 2007, with GlaxoSmithKline expecting subsequent approval in other European countries. According to the US government classification of psychiatric medications, bupropion is "non-abusable". Nixon AL, Long WH, Puopolo PR, Flood JG June 1995. "Bupropion metabolites produce false-positive urine amphetamine results". Clin. Chem. Thank you for your reply, and here is some additional information about Wellbutrin from rxlist.



Highlights for bupropion

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions. Cantwell DP 1998. "ADHD through the life span: the role of bupropion in treatment". J Clin Psychiatry. Your doctor may need to change your pain medication. But if you have read anything I have said and believe in the legitimacy of scientific studies and pharmacological fact then it is time to give up the habit before you find yourself with your face split open at the bottom of a stairwell, unable to move because you are in a post-hectal state and exhausted from all the writhing and rigid flailing you had just done for fifteen minutes as a result of a grand mal seizure. But hey, the good part is that you survived a grand mal seizure! These drugs can help control impulsivity and hyperactivity symptoms. January 2007. Press release. GlaxoSmithKline. Major depressive disorder Aplenzin, Forfivo XL, Wellbutrin, Wellbutrin SR, Wellbutrin XL: Treatment of major depressive disorder MDD. ADHD medicines are available. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing. Pisani F, Oteri G, Costa C, Di Raimondo G, Di Perri R 2002. "Effects of psychotropic drugs on seizure threshold". That's always good, right? Waknine, Yael 8 May 2008. Bupropion is extensively metabolized in the liver to active metabolites, which are further metabolized and subsequently excreted by the kidneys. The elimination of the major metabolites of Bupropion may be reduced by impaired renal function. For the prevention of seasonal MDD episodes associated with SAD, initiate Bupropion hydrochloride extended-release tablets XL in the autumn, prior to the onset of depressive symptoms. Continue treatment through the winter season. Taper and discontinue Bupropion hydrochloride extended-release tablets XL in early spring. For patients treated with 300 mg per day, decrease the dose to 150 mg once daily before discontinuing Bupropion hydrochloride extended-release tablets XL. generic leflunomide order pharmacy



How should i take bupropion

Today Msnbc. Retrieved 2009-06-23. Retrieved 13 May 2007. Lumacaftor: May decrease the serum concentration of CYP2B6 Substrates. Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Jefferson JW, Pradko JF, Muir KT November 2005. "Bupropion for major depressive disorder: Pharmacokinetic and formulation considerations". Clin Ther. Advise the patient to read the FDA-approved patient labeling Medication Guide. Wellbutrin XL 300 mg. FDA has asked these companies to submit the data from those studies no later than March 2013. Wilkins. p. 359. ISBN 0-7817-6587-0. Medications that alter urinary pH will cause variations in the amount and method of excretion, and usage should be monitored when taken concurrently with Adderall. White N, Litovitz T, Clancy C December 2008.



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Retrieved 13 October 2007


How to use bupropion

Beuhler MC, Spiller HA, Sasser HC March 2010. Thanks for coming back to let us know what its like, I was super curious as I've read in a few other places similar details. Sucks it has to be in a pill form that is unsuitable for IV though. Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. altal.info fenofibrate

Bupropion adult dosage

For example, you can learn how to replace negative thoughts with more realistic ones. Get emergency medical help if you have signs of an allergic reaction: hives, rash or itching; fever, swollen glands, joint pain, general ill feeling; difficult breathing; swelling of your face, lips, tongue, or throat. Your doctor may check your blood pressure before starting treatment and regularly while you are taking this medication, especially if you also are using nicotine replacement therapy. Use this medication regularly in order to get the most benefit from it. To help you remember, use it at the same times each day.

CNN 14 June 2006

Xu H, Loboz KK, Gross AS, McLachlan AJ March 2007. "Stereoselective analysis of hydroxybupropion and application to drug interaction studies". Chirality. Public Health Advisory for Adderall and Adderall XR”. Food and Drug Administration. 2009-04-30. Retrieved 2009-06-23. Pliszka S July 2007. In large doses -- greater than what is typically prescribed for ADHD -- Ritalin does have effects similar to those of cocaine. However, researchers have found marked differences between the two drugs. One of the factors that leads to addiction and drug abuse is how quickly a drug raises dopamine levels. The faster dopamine levels go up, the greater the potential for abuse. can i use avana

Bupropion side effects

Smoking cessation Zyban, Buproban: Initial: 150 mg once daily for 3 days; increase to 150 mg twice daily; treatment should continue for 7 to 12 weeks maximum dose: 300 mg daily. High blood pressure hypertension: Some people get high blood pressure that can be severe, while taking Bupropion hydrochloride extended-release tablets XL. The chance of high blood pressure may be higher if you also use nicotine replacement therapy such as a nicotine patch to help you stop smoking. Following oral administration of Bupropion 300 mg with and without cimetidine 800 mg in 24 healthy young male volunteers, the pharmacokinetics of Bupropion and hydroxyBupropion were unaffected. However, there were 16% and 32% increases in the AUC and C max, respectively, of the combined moieties of threohydroBupropion and erythrohydroBupropion.

Hydrobromide salt Aplenzin: Initial: 174 mg once daily in the morning; may increase as early as day 4 of dosing to 348 mg once daily target dose; maximum dose: 522 mg daily. Rosack, J 7 October 2005. “Canada reverses ban on ADHD medication”. Psychiatric News American Psychiatric Association 40 19: 2. ISSN 1559-1255. Retrieved 2009-06-23. Antidepressants increased the risk of suicidal thoughts and behavior in children, adolescents, and young adults in short-term trials. These trials did not show an increase in the risk of suicidal thoughts and behavior with antidepressant use in subjects aged 65 and older. In patients of all ages who are started on antidepressant therapy, monitor closely for worsening and for emergence of suicidal thoughts and behaviors, particularly during the initial 1 to 2 months of therapy or during periods of dosage adjustments increases or decreases; advise families and caregivers of the need for close observation and communication with the prescriber. A medication guide concerning the use of antidepressants should be dispensed with each prescription.

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