What should I watch for?
Visit your doctor or health care professional for regular checks on your progress. It may be several weeks before you see the full effects of this medicine. Do not suddenly stop taking this medicine. You may need to gradually reduce the dose.
Patients and their families should watch out for worsening depression or thoughts of suicide. Also watch out for sudden changes in feelings such as feeling anxious, agitated, panicky, irritable, hostile, aggressive, impulsive, severely restless, overly excited and hyperactive, or not being able to sleep. If this happens, especially at the beginning of antidepressant treatment or after a change in dose, call your health care professional.
You may get dizzy or drowsy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this medicine affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol can increase dizziness and drowsiness. Avoid alcoholic drinks.
This medicine can reduce the response of your body to heat or cold. Dress warm in cold weather and stay hydrated in hot weather. If possible, avoid extreme temperatures like saunas, hot tubs, very hot or cold showers, or activities that can cause dehydration such as vigorous exercise.
This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your eye doctor if the problem does not go away or is severe.
If you notice an increased hunger or thirst, different from your normal hunger or thirst, or if you find that you have to urinate more frequently, you should contact your health care provider as soon as possible. You may need to have your blood sugar monitored. This medicine may cause changes in your blood sugar levels. You should monitor you blood sugar frequently if you have diabetes.
There have been reports of uncontrollable and strong urges to gamble, binge eat, shop, and have sex while taking this medicine. If you experience any of these or other uncontrollable and strong urges while taking this medicine, you should report it to your health care provider as soon as possible.
Common and Rare Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Difficulty with speaking
loss of balance control
muscle trembling, jerking, or stiffness
stiffness of the limbs
twisting movements of the body
uncontrolled movements, especially of the face, neck, and back
inability to move the eyes
increased blinking or spasms of the eyelid
pounding in the ears
slow or fast heartbeat
sticking out the tongue
trouble with breathing or swallowing
unusual facial expressions
high or low blood pressure
lip smacking or puckering
loss of bladder control
muscle spasm or jerking of all extremities
puffing of the cheeks
rapid or worm-like movements of the tongue
severe muscle stiffness
sudden loss of consciousness
uncontrolled chewing movements
uncontrolled movements of the arms and legs
unusually pale skin
Incidence not known
itching, puffiness, or swelling of the eyelids or around the eyes, face, lips, or tongue
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
redness of the skin
tightness in the chest
unusual tiredness or weakness
Get emergency help immediately if any of the following symptoms of overdose occur:
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Acid or sour stomach
difficulty having a bowel movement (stool)
inability to sit still
need to keep moving
stomach discomfort, upset, or pain
bloating or swelling of the face, arms, hands, lower legs, or feet
body aches or pain
difficulty with moving
dryness or soreness of the throat
muscle aching or cramping
muscle pains or stiffness
rapid weight gain
tender, swollen glands in the neck
tingling of the hands or feet
unusual weight gain or loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.