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Sarafem costs 50 more than prozac and prozac costs more than generic fluoxetine, leading many to question whether sarafem is worth the extra money.

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Thioridazine administration produces a dose-related prolongation of the QTc intervalwhich is associated with serious ventricular arrhythmiassuch as torsades de pointes-type arrhythmiasand sudden deathThis risk is expected to increase with fluoxetine-induced inhibition of thioridazine metabolism.

Serotonin syndrome symptoms may include mental status changesfor exampleagitationhallucinationsdeliriumand comaautonomic instabilityfor exampletachycardialabile blood pressuredizzinessdiaphoresisflushinghyperthermianeuromuscular symptomsfor exampletremorrigiditymyoclonushyperreflexiaincoordinationseizuresand/or gastrointestinal symptomsfor examplenauseavomitingdiarrheaPatients should be monitored for the emergence of serotonin syndrome.

SNRIs and SSRIsincluding fluoxetinemay increase the risk of bleeding reactionsConcomitant use of aspirinnonsteroidal anti-inflammatory drugswarfarinand other anti-coagulants may add to this riskCase reports and epidemiological studiescase-control and cohort designhave demonstrated an association between use of drugs that interfere with serotonin reuptake and the occurrence of gastrointestinal bleedingBleeding reactions related to SNRIs and SSRIs use have ranged from ecchymoseshematomasepistaxisand petechiae to life-threatening hemorrhages.

Families and caregivers of patients being treated with antidepressants for Major Depressive Disorder or other indicationsboth psychiatric and nonpsychiatricshould be alerted about the need to monitor patients for the emergence of agitationirritabilityunusual changes in behaviorand the other symptoms described aboveas well as the emergence of suicidalityand to report such symptoms immediately to health care providersSuch monitoring should include daily observation by families and caregiversPrescriptions for SARAFEM should be written for the smallest quantity of tablets consistent with good patient managementin order to reduce the risk of overdose.

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systematic evaluation of sarafem has shown that its efficacy in pmdd is maintained for periods of up to 6 months at a dose of 20 mg day given continuously and up to 3 months at a dose of 20 mg day given intermittently see clinical studies .

Posted: 09月 6th, 2018
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