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The drug was taken for 14 days premenstrually for only three menstrual cycles. Stamford, Conn.: Appleton & Lange, 1999;1154–5Fluoxetine may be an appropriate antidepressant choice in patients with hypersomnia or psychomotor retardation and should probably be avoided in patients with concomitant anxiety, panic, and agitation.3Sertraline (Zoloft) is begun at a dosage of 50 mg per day and titrated to a dosage range of 100 to 200 mg per day in a single daily dose or divided daily doses12 .

Seventy-five percent of the women reported significant improvement in premenstrual symptoms. In elderly patients or patients with concomitant anxiety disorders, a starting dose of 25 mg per day is recommended.

Selective serotonin reuptake inhibitors have become the drugs of choice in the treatment of depression, and they are also effective in the treatment of obsessive-compulsive disorder, panic disorder, and social phobia.

Mirtazapine, which is unrelated to the selective serotonin reuptake inhibitors, is unique in its action—stimulating the release of norepinephrine and serotonin.

Prozac Weekly is a capsule with pellets containing 90 mg of fluoxetine hydrochloride.

The enteric coating prevents dissolution of the pellets until they have passed into the portion of the gastrointestinal tract where the p H exceeds 5.5.6 In a study8 of 500 patients with depression, the percentage of patients relapsing during continuation treatment with a 90-mg weekly dose was not significantly different from those taking a 20-mg daily dose. Weekly dosing is recommended to begin seven days after the last daily dose of 20 mg .

Fluoxetine is now available in a special form taken once-weekly for continuation therapy of depression.

The choice of antidepressant drug depends on the agent's pharmacologic profile, secondary actions, and tolerability.

Sexual dysfunction related to the use of antidepressants may be addressed by reducing the dosage, switching to another agent, or adding another drug to overcome the sexual side effects.

Cost to patient will be higher depending on filling fees Costs are average wholesale prices for 30 days of the lowest-dose therapy from Red Book. J.: Medical Economics Data, 2002, rounded to the nearest dollar.

Cost to patient will be higher depending on filling fees Numerous double-blind, placebo-controlled trials have demonstrated the efficacy of SSRIs in the treatment of depression.

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