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A major depressive episode may be the initial presentation of Bipolar DisorderIt is generally believedthough not established in controlled trialsthat treating such an episode with an antidepressant alone may increase the likelihood of precipitation of a mixed/manic episode in patients at risk for Bipolar DisorderWhether any of the symptoms described for clinical worsening and suicide risk represent such a conversion is unknownHoweverprior to initiating treatment with an antidepressantpatients with depressive symptoms should be adequately screened to determine if they are at risk for Bipolar Disordersuch screening should include a detailed psychiatric historyincluding a family history of suicideBipolar Disorderand depressionIt should be noted that SARAFEM is not indicated for the treatment of depressive episodes associated with Bipolar I Disorder.
Treatment with SARAFEM and any concomitant serotonergic agentsshould be discontinued immediately if the above events occur and supportive symptomatic treatment should be initiated.
SARAFEM has the potential to impair judgmentthinkingor motor skillsPatients should be cautioned about operating hazardous machineryincluding automobilesuntil they are reasonably certain that the drug treatment does not affect them adversely.
Read the Medication Guide provided by your pharmacist before you start using fluoxetine and each time you get a refillIf you have any questionsask your doctor or pharmacist.
Patients should be cautioned about the risk of serotonin syndrome with the concomitant use of SARAFEM and other serotonergic agents including triptanstricyclic antidepressantsfentanyllithiumtramadolbuspironetryptophanand StJohn’s Wortsee CONTRAINDICATIONSWARNINGS AND PRECAUTIONSand DRUG INTERACTIONS
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you should inform your doctor if you are already taking any of the following drugs before he prescribes risperidone zydus pharmaceuticals alcohol; anafranil; antihypertensives; anzemet; asendin; atamet; avelox; aventyl; betapace; biaxin; central nervous system depressants; clozaril; cordarone; covert; dopar; elavil; e-mycin; epitol; geodon; haldol; halfan; imitrex; inapsine; lariam; larodopa; larodopa; levaquin; mellaril; mirapex; norpace; norpramin; norpramin; orap; orlaam; parlodel; paxil; permax; procainbid; pronestyl; propulsid; prozac; quinaglute; quinidex; requip; rythmol; sarafem; serentil; sinemet; sinequan; sorine; surmontil; tegretol; tequin; thorazine; tikosyn; tofranil; trisenox; vascor; vivactil; zofran; zomig.