Epilepsy, patients w/ history of seizures, emotional disturbances or suicidal ideation or attempts, risk for resp depression. Increased ICP or head trauma. Concomitant use of serotonergic drugs eg, SSRIs, SNRIs, TCAs, MAOIs, triptans & alcohol; w/drawal symptoms upon abrupt discontinuation. Hepatic impairment. May affect ability to drive or operate machinery. Pregnancy & lactation.