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Patients should be monitored for these symptoms when discontinuing treatment with SARAFEMA gradual reduction in the dose rather than abrupt cessation is recommended whenever possibleIf intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatmentthen resuming the previously prescribed dose may be consideredSubsequentlythe dose may continue to be decreased but at a more gradual ratePlasma fluoxetine and norfluoxetine concentration decrease gradually at the conclusion of therapy which may minimize the risk of discontinuation symptoms with this drug.

All patients being treated with antidepressants for any indication should be monitored appropriately and observed closely for clinical worseningsuicidalityand unusual changes in behaviorespecially during the initial few months of a course of drug therapyor at times of dos e changeseither increases or decreases

Tell the doctor right away if you notice worsening depression/other psychiatric conditionsunusual behavior changesincluding possible suicidal thoughts/attemptsor other mental/mood changesincluding new/worsening anxietypanic attackstrouble sleepingirritabilityhostile/angry feelingsimpulsive actionssevere restlessnessvery rapid speechBe especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

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