This is a selective serotonin reuptake inhibitor (SSRI).

Indications: depressive illness (endogenous and non- endogenous depression) and generalizes anxiety disorder, panic disorder.

Cautions: cardiac disease, diabetes mellitus, susceptibility to angle-closure glaucoma, a history of mania or bleeding disorders (especially gastro-intestinal bleeding), and if used with other drugs that increase the risk of bleeding, hepatic impairment, renal impairment, pregnancy, and breast-feeding: should not be given to patients on MAOI's for at least 14 days after discontinuation; Conversely, an MAOI should not be started until at least a week after antidepressant has been stopped.

Contra-indications: if the patient enters a manic phase, the drug should be discontinued and treatment with a neuroleptic should be started.

Side Effects: nausea and reduced salivation, headache and reduced duration of sleep postural hypotension, sinusitis, fatigue; hypersensitivity reactions including rash (consider discontinuation—may be sign of impending serious systemic reaction, possibly associated with vasculitis), urticaria, angioedema, anaphylaxis, arthralgia, myalgia and photosensitivity; galactorrhoea, sexual dysfunction, urinary retention, sweating, hypomania or mania, movement disorders and dyskinesias, visual disturbances, hyponatraemia, and bleeding disorders including ecchymoses and purpura. Suicidal behaviour has been linked with antidepressants.

Dose: initially 10 mg once daily could be increased to max. 20 mg

Max. dose is 20 mg once daily.

Elderly, half the recommended dose i.e. 10- mg/day. Manic depressive illness, treatment should continue for at least 4-6 months.