Serotonin syndrome or neuroleptic malignant syndrome. Activation of hypomania or mania; schizophrenia; seizures; suicide/suicidal thoughts/suicide attempts or clinical worsening. Abnormal bleeding/hemorrhage; hyponatremia. Akathisia/psychomotor restlessness. Diabetes. Switching from SSRIs, antidepressants or anti-obsessional drugs; other serotonergic drugs eg, tryptophan, fenfluramine, 5-HT agonists. Electroconvulsive therapy. W/drawal symptoms. May affect ability to drive & use machines. Hepatic & renal impairment. Childn. Elderly.