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. Author manuscript; available in PMC: 2016 Jun 24.
Published in final edited form as: Curr Treat Options Neurol. 2014 Nov;16(11):319. doi: 10.1007/s11940-014-0319-0
Standard dosage 10 mg daily to 40 mg daily
Contraindications concomitant use with a monoamine oxidase inhibitor (MAOi), IV methylene
blue, linezolid may lead to increased risk of serotonin syndrome
Main drug interactions other medications that may prolong QTc interval, primarily metabolized by
CYP2C19, 2D6, and 3A4. Weak inhibitor of 2D6.
Main side effects diaphoresis, nausea, xerostomia, dizziness, headache, insomnia, somnolence,
tremor, prolonged QTc interval, rare worsening depression
Special points special consideration should be placed on risk of QTc prolongation, especially
on 40 mg daily dose, strong caution against doses exceeding 20 mg in the
elderly
Cost inexpensive
Standard dosage 5 mg daily to 20 mg daily
Contraindications concomitant use with a monoamine oxidase inhibitor (MAOi), IV methylene
blue, linezolid may lead to increased risk of serotonin syndrome
Main drug interactions metabolized by CYP2C19, 3A4
Main side effects diaphoresis, diarrhea, nausea, headache, insomnia, somnolence
Special points relatively selective SSRI and fewer drug interactions than others
Cost relatively more expensive compared to other oral medications
Standard dosage 25 mg daily to 200 mg daily
Contraindications concomitant use of disulfiram, concomitant use with a monoamine oxidase
inhibitor (MAOi), IV methylene blue, linezolid may lead to increased risk of
serotonin syndrome
Main drug interactions metabolized by CYP450 2C19, inhibitor of 2D6, 3A4
Main side effects diarrhea, indigestion, nausea, dizziness, headache, insomnia, somnolence, re-
duced libido, fatigue, rash, hyponatremia
Special points also has mild dopaminergic actions
Cost inexpensive
Standard dosage oral 12.5 mg daily to 400 mg a day divided by twice a day or three times a day
Contraindications concomitant use with a monoamine oxidase inhibitor (MAOi), IV methylene
blue, linezolid may lead to increased risk of serotonin syndrome, concomitant
use with saquinavir/ritonavir
Main drug interactions extensive CYP450 3A4 metabolism
Main side effects nausea, headache, somnolence, blurred vision, fatigue, prolonged QT, rare
seizures
Special points has sedating properties and may be helpful for patients with insomnia or
agitation, may cause worsening of cognition at higher doses
Cost inexpensive