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Families and caregivers of patients being treated with antidepressants for Major Depressive Disorder or other indicationsboth psychiatric and nonpsychiatricshould be alerted about the need to monitor patients for the emergence of agitationirritabilityunusual changes in behaviorand the other symptoms described aboveas well as the emergence of suicidalityand to report such symptoms immediately to health care providersSuch monitoring should include daily observation by families and caregiversPrescriptions for SARAFEM should be written for the smallest quantity of tablets consistent with good patient managementin order to reduce the risk of overdose.

Whether these systemic reactions and rash have a common underlying cause or are due to different etiologies or pathogenic processes is not knownFurthermorea specific underlying immunologic basis for these reactions has not been identifiedUpon the appearance of rash or of other possibly allergic phenomena for which an alternative etiology cannot be identifiedSARAFEM should be discontinued.

The potential for interaction by a variety of mechanismsfor examplepharmacodynamicpharmacokinetic drug inhibition or enhancementetcis a possibility.

During or within 14 days of MAOIsdo not start an MAOI during or within 5 weeks of fluoxetineConcomitant pimozidethioridazinelinezolidIV methylene blue.

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