Adult <65 yr Initially 10 mg once daily, may be increased to max 20 mg once daily or decreased to min 5 mg once daily. Elderly ≥65 yr Initially 5 mg once daily.
Discontinue use if seizures or increased seizure frequency, signs & symptoms of serotonin syndrome or neuroleptic malignant syndrome, symptomatic hyponatraemia occur; in patients entering manic phase. Monitor suicidal behaviour, thoughts or clinical worsening. History of suicide-related events or exhibiting significant degree of suicidal ideation; seizures or unstable epilepsy; mania/hypomania; known bleeding tendencies/disorders. Concomitant use w/ anticoagulants &/or drugs affecting platelet function eg, atypical antipsychotics & phenothiazines, most TCAs, NSAIDs, acetylsalicylic acid; drugs causing hyponatraemia. May affect ability to drive & use machines. Liver cirrhosis. Severe renal & hepatic impairment. Pregnancy & lactation. Not recommended in childn & adolescents <18 yr. Elderly ≥65 yr.
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