Depressive illness

Adult: Initially 50 mg daily, then increased in steps of 50 mg at intervals of at least 1 week if required; maintenance 50 mg daily; maximum 200 mg per day

Obsessive-compulsive disorder

Adult: Initially 50 mg daily, then increased in steps of 50 mg at intervals of at least 1 week if required; maximum 200 mg per day

Panic disorder, Post-traumatic stress disorder, Social anxiety disorder

Adult: Initially 25 mg daily for 1 week, then increased to 50 mg daily, then increased in steps of 50 mg at intervals of at least 1 week if required, increase only if response is partial and if drug is tolerated; maximum 200 mg per day.

Breast Feeding Not known to be harmful but consider discontinuing breast-feeding.

Hepatic Impairment advised to avoid in severe impairment

Dose adjustments advised to dose reduction or increasing dose interval in mild to moderate impairment.

Treatment Cessation The dose should preferably be reduced gradually over about 4 weeks, or longer if withdrawal symptoms emerge (6 months in patients who have been on long-term maintenance treatment).

Patient and Carer Advice

Driving and skilled tasks Patients should be counselled on the effects on driving and skilled tasks.

Common or very common Chest pain, Depression, Gastrointestinal disorders, Increased risk of infection, Neuromuscular dysfunction, Vasodilation

Uncommon Back pain, Burping, Chills, Cold sweat, dysphagia, Dyspnoea, Ear pain, Euphoric mood, hypertension, Hypothyroidism, Migraine, Muscle complaints, Muscle weakness, Oedema, Oral disorders, osteoarthritis, Periorbital oedema, Respiratory disorders, Sensation abnormal, Speech disorder, Thinking abnormal thirst

Rare or very rare Balanoposthitis, Bone disorder, Cardiac disorder, Coma, Conversion disorder, Diabetes mellitus, Drug dependence, Dysphonia, Eye disorders, Gait abnormal, Genital discharge, Glaucoma, Hair texture abnormal, Hepatic disorders, Hiccups, hypercholesterolemia, Hypoglycaemia, Injury, lymphadenopathy, Myocardial infarction, Neoplasms, oliguria, Peripheral ischaemia, Psychotic disorder, vasodilation procedure, Vision disorders, Vulvovaginal atrophy

 Frequency not known cerebrovascular insufficiency, gynaecomastia, Hyperglycaemia, Leukopenia, Neuroleptic malignant syndrome, Pancreatitis

Store in a cool and dry place

10×14 Tablets