Major depressive episodes Initially 20 mg once daily, administer in the morning, may be gradually increased up to max 80 mg daily (60 mg in the elderly) if no clinical response after several wk. Doses >20 mg daily may be given in 2 divided doses (eg, in the morning & at noon) or as once daily dose.
Depression Childn ≥8 yr Initially 10 mg, increased to 20 mg daily after 1 wk (except in low wt childn when such increases should not be made for several wk, & then only if the clinical response is insufficient).
Bulimia nervosa 60 mg once daily.
Obsessive-compulsive disorder Initially 20 mg once daily, increased after several wk if there is no response to up to 60 mg daily. Up to 80 mg has been used, sometimes divided into 2 doses.
Childn ≥7 yr Initially 10 mg daily.
Low-wt childn Increased after several wk to 20-30 mg daily, if required.
Adolescent & heavier childn May be increased to 20 mg daily after 2 wk; may be further increased to 60 mg daily after several wk, as necessary.
Panic disorder Initially 10 mg once daily. After a wk, increased to 20 mg daily; may be further increased to 60 mg daily after several wk if no improvement.
Pre-menstrual dysphoric disorder 20 mg daily. Intermittent dosing: For each new cycle, start 14 days before onset of menstruation & continue until 1st full day of menstruation. Treatment may be continued for 6 mth then re-assess benefits before continuing further.
Elderly Lower or less frequent dose.
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