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Concomitant use of SARAFEMfluoxetinein patients taking MAOIs is contraindicatedThere have been reports of serioussometimes fatalreactionsincluding hyperthermiarigiditymyoclonusautonomic instability with possible rapid fluctuations of vital signsand mental status changes that include extreme agitation progressing to delirium and comain patients receiving fluoxetine in combination with a monoamine oxidase inhibitorMAOIand in patients who have recently discontinued fluoxetine and are then started on an MAOISome cases presented with features resembling neuroleptic malignant syndromeThereforefluoxetineincluding SARAFEMshould not be used in combination with an MAOIor within a minimum of 14 days of discontinuing therapy with an MAOIsee CONTRAINDICATIONSSince fluoxetine and its major metabolite have very long elimination half-livesat least 5 weeksperhaps longerespecially if fluoxetine has been prescribed chronically and/or at higher dosesshould be allowed after stopping fluoxetine before starting an MAOIsee DOSAGE AND ADMINISTRATIONCONTRAINDICATIONSWARNINGS AND PRECAUTIONSand CLINICAL PHARMACOLOGY
Table 4AnxietyNervousnessand InsomniaTreatment Discontinuation Rates in PMDD Placebo-Controlled Clinical Trials.
Table 3Anxiety and Insomnia Treatment Emergent Adverse ReactionsIncidence in PMDD Placebo-Controlled Clinical Trials.
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tell your doctor if you are taking buspirone buspar , epinephrine epipen , medications for migraine such as almotriptan axert , eletriptan relpax , frovatriptan frova , naratriptan amerge , rizatriptan maxalt , sumatriptan imitrex , and zolmitriptan zomig , meperidine demerol , pseudoephedrine sudafed, in many cold or decongestant medications selective serotonin reuptake inhibitors ssris such as citalopram celexa , escitalopram lexapro , fluoxetine prozac, sarafem, symbyax , fluvoxamine luvox , paroxetine paxil , sertraline zoloft , and vilazodone vilbyrd , serotonin norepinephrine reuptake inhibitors snris such as desvenlafaxine pristiq , duloxetine cymbalta , and venlafaxine effexor , and tricyclic antidepressants such as amitriptyline elavil , amoxapine asendin , clomipramine anafranil , desipramine norpramin , doxepin adapin, sinequan , imipramine tofranil , nortriptyline aventyl, pamelor , protriptyline vivactil , and trimipramine surmontil .
