Anxiety states, mixed anxiety-depression or neurotic or reactive depression w/ or w/o other diseases eg, chronic phase of alcohol w/drawal & functional or organic disease, particularly certain GI, CV or dermatological disorders. Panic disorder w/ or w/o agoraphobia.
May be habit-forming on prolonged use. May lead to development of physical or psychic dependence. Effectiveness for long-term use >6 mth has not been established. Pre-existing depression may be unmasked during use. Do not use alone to treat depression or depression-associated anxiety due to risk of precipitating suicide. Do not use in patients whose primary symptom of depression is psychomotor retardation; w/ diagnosis of bipolar depression; w/ psychotic symptoms. Not recommended in patients whose primary diagnosis is schizophrenia. W/drawal symptoms have occurred following rapid decrease or abrupt discontinuation. Avoid abrupt discontinuation & perform gradual dose tapering. Risk of anaphylaxis & angioedema as early as treatment initiation; complex sleep-related behaviors; anterograde amnesia; paradoxical reactions, most likely in childn & elderly. Lower doses for patients who have not previously received psychotropic medications than for those previously treated w/ minor tranquilizers, antidepressants or hypnotics or those w/ history of chronic alcoholism. Lower doses for patients w/ chronic resp insufficiency due to risk of resp depression. Not indicated to treat patients w/ severe hepatic insufficiency due to risk of precipitating encephalopathy. May impair ability to drive or operate machinery. Patients w/ renal or hepatic impairment; borderline personality disorder, prior history of violent or aggressive behaviour, or alcohol or substance abuse; post-traumatic stress disorder. Avoid during pregnancy. Do not breastfeed during treatment. Childn <18 yr. Elderly or debilitated patients.
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