Adult:
As conventional tablets: Initially, 75 mg daily in 2 or 3 divided doses, increased to 150 mg daily after several wk if necessary, further increase may be made in increments of up to 75 mg, every 2-4 days. Max: 375 mg daily
Oral
GENERALISED ANXIETY DISORDER
Adult:
As modified-release preparation: Initially, 75 mg once daily, adjusted in increments of up to 75 mg , at intervals of at least 4 days. Max 225 mg daily. Withdraw gradually if no response after 8 wk.
Oral
SOCIAL ANXIETY DISORDER
Adult:
As modified-release preparation: Initially, 75 mg once daily, adjusted in increments of up to 75 mg , at intervals of at least 4 days. Max 225 mg daily. Withdraw gradually if no response after 8 wk.
Oral
PANIC DISORDER
Adult:
37.5 mg once daily for first 7 days, then increased to 75 mg daily; increase by up to 75 mg at intervals of at least 7 days as needed. Max: 225 mg daily.
Administration
Should be taken with food.
Precautions
Moderate to severe renal or hepatic impairment. Conditions which may be worsened by increase in heart rate. History of MI, bleeding disorder, epilepsy, hypomania or mania. Raised IOP or at risk at angle-closure glaucoma. May impair performance of skilled tasks, driving or machinery operation. Monitor BP and serum cholesterol regularly. Monitor closely during early therapy until depression improves due to increased risk of suicide. Avoid abrupt withdrawal. Withdraw gradually over at least 1-2 wk and monitor for withdrawal symptoms e.g. fatigue, headache, nausea, vomiting, palpitations. Discontinue if seizure develops or increase in seizure frequency. Elderly, pregnancy.
Potentially Life-threatening
Adverse Drug Reactions
Nausea, vomiting, anorexia, dry mouth, constipation, orthostatic hypotension, tremor, sweating, rash, anxiety, dizziness, fatigue, headache, syncope, insomnia, somnolence, constipation, hyponatraemia, sexual dysfunction, dyspepsia, visual disturbances, mydriasis, increased cholesterol concentrations, increased LFT. Aggressive behaviour (especially at the start and when stoppping therapy).
Increased risk of serotonin syndrome with MAOI, do not use within at least 14 days of discontinuing MAOI treatment and start MAOI at least 7 days after stopping venlafaxine. Increased risk of serotonin syndrome with sibutramine.
