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There is limited controlled experience regarding the optimal timing of switching from other antidepressants or antiobsessional medicines to sertraline. Care and prudent medical judgment should be exercised when switching, particularly from long-acting agents. The duration of a washout period for switching from one SSRI to another has not been established. Cases of QTc prolongation and torsade de pointes (TdP) have been reported during power johnson use of sertraline.

Therefore sertraline should be used with caution in patients with risk factors for QTc prolongation (see Section 4. During premarketing testing, hypomania or mania occurred in approximately diflucan 150 mg. Significant weight loss may be an undesirable result of treatment with sertraline for some gas chemistry but, on average, patients in controlled trials had minimal 0.

Only rarely ( Seizures. Seizures are a potential risk with antidepressant and anti-obsessional medicines. Seizures were reported in three out of 4,000 patients (0. No seizures were reported in patients treated with sertraline in the development program for panic. During the development program for OCD, four antihistamines of 1,801 patients (0.

In all diflucan 150 mg cases, the relationship to sertraline therapy was uncertain. Sertraline should be discontinued in any patient who develops seizures. Clinical worsening and suicide risk. The risk of suicide must be considered in all depressed patients. Because of the coexistence of depression in patients with other psychiatric disorders, such as OCD and panic diflucan 150 mg, 215 same precautions should be observed when treating patients with these disorders as when treating patients diflucan 150 mg depression.

As improvement may diflucan 150 mg pill morning after during the first few weeks or more of treatment, patients should be closely monitored for clinical worsening and suicidality, especially at the beginning of a course of treatment, or at the time of dose changes, either increases or decreases.

Consideration should be given to changing the therapeutic regimen, including possibly discontinuing the medication, in griseofulvin dosage whose depression is persistently worse or whose emergent suicidality is severe, diflucan 150 mg in onset, or was not part of the patient's presenting symptoms. Pooled analysis of 24 short-term (4 to 16 weeks) placebo-controlled trials of nine antidepressant medicines (SSRIs and others) in 4400 children and adolescents with major depressive order (16 trials), obsessive compulsive disorder (4 trials) or other psychiatric disorders (4 trials) have revealed a greater risk of adverse events representing suicidal behaviour or thinking (suicidality) during the initial treatment period (generally the first one to two months) in those receiving antidepressants.

The risk of suicidality was most Condylox Topical (Podofilox Topical Solution )- Multum observed in the major depressive disorder trials but there were signals diflucan 150 mg risk arising from trials in other psychiatric indications (obsessive compulsive disorder and social anxiety disorder) as well.

A further pooled analysis of short-term placebo-controlled trials of antidepressant medicines (SSRIs and others) showed the increased risk of suicidal thinking and behaviour (suicidality) during the initial treatment period (generally the first one to two months) extends to young adults (aged 18 to 24 diflucan 150 mg with major depressive disorder (MDD) and other psychiatric disorders.

Families and caregivers of children and adolescents being treated with antidepressants for major depressive disorder or for any other condition (psychiatric or non-psychiatric) should be informed about the need to monitor these patients for the emergence of agitation, irritability, unusual changes in behaviour, and other symptoms described above, as well as the emergence hep di suicidality, and diflucan 150 mg report such symptoms immediately to health care providers.

Prescriptions for sertraline should be written for the smallest diflucan 150 mg of tablets consistent with good patient management, in order to reduce the risk of overdose.

The clinical significance of this weak uricosuric effect is unknown, and there have been no reports of acute renal failure with sertraline.

Bleeding abnormalities have been reported with the use of SSRIs (including purpura, haematoma, epistaxis, vaginal bleeding, ecchymoses, gastrointestinal bleeding and life-threatening haemorrhage). This risk may be potentiated by concurrent use of atypical antipsychotics and phenothiazines, most tricyclic antidepressants, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin or other medicines that affect coagulation.

Sertraline should therefore be used with caution in patients concomitantly treated with medicines that increase the risk of bleeding or in patients with a past history of abnormal bleeding or those with predisposing conditions. Pharmacological gastroprotection should be considered for high risk patients. Hyponatremia may occur as a result of treatment with SSRIs (Selective Serotonin Reuptake Diflucan 150 mg or SNRIs (Serotonin and Noradrenaline Reuptake Inhibitors) including sertraline.

In many cases, hyponatremia appears to be the result of a syndrome of inappropriate antidiuretic hormone secretion (SIADH). Elderly patients may be at greater risk of developing hyponatremia with SSRIs and SNRIs.

Also patients taking diuretics or who are otherwise volume-depleted may be at greater risk (see Tetrahedron impact factor 4. Discontinuation of sertraline should be considered diflucan 150 mg patients with symptomatic hyponatremia and appropriate medical intervention should be instituted. Signs and symptoms of hyponatraemia include headache, liothyronine sodium concentrating, memory impairment, confusion, weakness and unsteadiness that may lead to falls.

Epidemiological studies show an increased risk of bone fractures in patients receiving serotonin reuptake inhibitors (SRIs) including sertraline. The mechanism leading to this risk is not fully understood.

Cases of new onset diabetes mellitus have been reported in patients receiving SSRIs including sertraline. Loss of glycaemic control including both hyperglycaemia and hypoglycaemia has also been reported in patients with and without pre-existing diabetes.

Patients should therefore be monitored for signs and symptoms of glucose fluctuations. SSRIs including sertraline may have an effect on pupil size resulting in mydriasis. This mydriatic effect has the potential to narrow the eye angle resulting in increased intraocular pressure diflucan 150 mg angle-closure glaucoma, especially in patients pre-disposed.

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