OTHER USES: This medication has also been used to treat a severe form of premenstrual syndrome (premenstrual dysphoric disorder- PMDD) and a sexual function problem in men (premature ejaculation).

HOW TO USE: Take this medication by mouth usually once daily with or without food; or as directed by your doctor. It is recommended that you take your dosage at the same time each day, either in the morning or in the evening. The dosage is based on your medical condition and response to therapy. It is important to continue taking this medication as prescribed even if you feel well. Also, do not stop taking this medication without consulting your doctor. It may take up to 4 weeks before the full benefit of this drug takes effect.

SIDE EFFECTS: Nausea, headache, diarrhea, trouble sleeping, dry mouth, drowsiness, dizziness, or upset stomach may occur. If any of these effects persist or worsen, notify your doctor promptly. Tell your doctor immediately if any of these serious side effects occur: loss of appetite, unusual weight loss, unusual or severe mental/mood changes, increased sweating/flushing, unusual fatigue, uncontrolled movements (tremor), decreased interest in sex. Tell your doctor immediately if any of these unlikely but serious side effects occur: vision changes, changes in sexual ability, painful and/or prolonged erection. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: fainting, irregular heartbeat, chest pain, muscle pain, trouble swallowing, ringing in in the ears, seizures. An allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include: rash, itching, swelling, severe dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

PRECAUTIONS: Tell your doctor your medical history, especially of: liver problems, kidney disease, seizures, heart problems, any allergies. This drug may make you dizzy or drowsy; use caution engaging in activities requiring alertness such as driving or using machinery. Limit alcoholic beverages. Caution is advised when using this product in the elderly because they may be more sensitive to the effects of the drug. This medication should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug passes into breast milk. Because of the potential risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

DRUG INTERACTIONS: Certain medications taken with this product could result in serious, even fatal, drug interactions. Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, selegiline, tranylcypromine) within 2 weeks before or after treatment with this medication. Consult your doctor or pharmacist for additional information. This drug is not recommended for use with: weight loss drugs (e.g., sibutramine, phentermine), terfenadine, astemizole. Ask your doctor or pharmacist for more details. Tell your doctor of all prescription and nonprescription medication you may use, especially: other SSRI antidepressants (e.g., citalopram, fluoxetine), nefazodone, venlafaxine, "triptan" migraine drugs (e.g., sumatriptan, zolmitriptan), tramadol, tricyclic antidepressants (e.g., amitriptyline, nortriptyline), cimetidine, flecainide, propafenone, clozapine, trazodone, lithium, tryptophan, "blood thinners" (e.g., warfarin), any herbal/natural products (e.g., melatonin, St John's wort, ayahuasca). Tell your doctor if you take any drugs that cause drowsiness such as: medicine for sleep, sedatives, tranquilizers, anti- anxiety drugs (e.g., diazepam), narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., phenothiazines such as chlorpromazine), anti-seizure drugs (e.g., carbamazepine), muscle relaxants, certain antihistamines (e.g., diphenhydramine). Report other drugs which affect the heart rhythm (QTc prolongation), such as: dofetilide, pimozide, sotalol, quinidine, procainamide, sparfloxacin, "water pills" (diuretics such as furosemide or hydrochlorothiazide). Ask your doctor or pharmacist for more details. Do not start or stop any medicine without doctor or pharmacist approval.

OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include: irregular heartbeat, fainting, severe dizziness or lightheadedness.

NOTES: Do not share this medication with others. Laboratory and/or medical tests may be performed to monitor your progress.

MISSED DOSE: If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

STORAGE: Store at room temperature between 59 and 86 degrees F (15 and 30 degrees C) away from light and moisture.