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During marketing of SARAFEMSNRIsand SSRIsthere have been spontaneous reports of adverse reactions occurring upon discontinuation of these drugsparticularly when abruptincluding the followingdysphoric moodirritabilityagitationdizzinesssensory disturbancesfor exampleparesthesias such as electric shock prescription drug online. sensationsanxietyconfusionheadachelethargyemotional labilityinsomniaand hypomaniaWhile these reactions are generally self-limitingthere have been reports of serious discontinuation symptoms.

Five patients receiving fluoxetine in combination with tryptophan experienced adverse reactionsincluding agitationrestlessnessand gastrointestinal distressThe concomitant use with tryptophan is not recommendedsee WARNINGS AND PRECAUTIONS

Do not start SARAFEM in a patient who is being treated with linezolid or intravenous methylene blue because there is an increased risk of serotonin syndromeIn a patient who requires more urgent treatment of a psychiatric conditionother interventionsincluding hospitalizationshould be consideredsee CONTRAINDICATIONS

The following adverse reactions have been identified during post approval use of fluoxetineBecause these reactions are reported voluntarily from a population of uncertain sizeit is difficult to reliably estimate their frequency or evaluate a causal relationship to drug exposure.

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