WARNING: ANTIDEPRESSANTS MAY INCREASE THE RISK of suicidal thoughts or actions in children, teenagers, and young adults. However, depression and certain other mental problems may also increase the risk of suicide. Talk with the patient's doctor to be sure that the benefits of using this medicine outweigh the risks. FAMILIES AND CAREGIVERS MUST CLOSELY WATCH PATIENTS who take this medicine. It is important to keep in close contact with the patient's doctor. Tell the doctor right away if the patient has symptoms like worsened depression, suicidal thoughts, or changes in behavior. Discuss any questions with the patient's doctor. Some medicines or medical conditions may interact with this medicine. INFORM YOUR DOCTOR OR PHARMACIST of all prescription and over-the-counter medicine that you are taking. DO NOT TAKE THIS MEDICINE if you are taking certain antiarrhythmics (eg, amiodarone, procainamide, quinidine, sotalol), certain antibiotics (eg, gatifloxacin, moxifloxacin), escitalopram, a fenfluramine derivative (eg, dexfenfluramine), levomethadyl, methadone, nefazodone, pentamidine, phenothiazines (eg, chlorpromazine, thioridazine), pimozide, serotonin-norepinephrine reuptake inhibitors (SNRIs) (eg, duloxetine, venlafaxine), sibutramine, other SSRIs (eg, fluoxetine, paroxetine), or tryptophan. DO NOT TAKE THIS MEDICINE if you are taking or have taken linezolid, a monoamine oxidase inhibitor (MAOI) (eg, phenelzine, selegiline), or St. John's wort within the last 14 days. ADDITIONAL MONITORING OF YOUR DOSE OR CONDITION may be needed if you are taking antiarrhythmics (eg, propafenone), anticoagulants (eg, warfarin), aripiprazole, arsenic, aspirin, beta-blockers (eg, propranolol), carbamazepine, cimetidine, clozapine, cyproheptadine, diuretics (eg, furosemide, hydrochlorothiazide), fentanyl, halofantrine, lithium, meperidine, metoclopramide, nilotinib, nonsteroidal anti-inflammatory drugs (NSAIDs) (eg, ibuprofen), omeprazole, ondansetron, risperidone, serotonin 5-HT1 receptor agonists (eg, sumatriptan), sibutramine, tramadol, trazodone, tricyclic antidepressants (eg, amitriptyline), vandetanib, or a medicine that contains methylene blue. TELL YOUR DOCTOR if you take any medicine that may increase the risk of a certain type of irregular heartbeat (prolonged QT interval). Check with your doctor or pharmacist if you are unsure if any of your medicines may increase the risk of this type of irregular heartbeat. DO NOT START OR STOP any medicine without doctor or pharmacist approval. Inform your doctor of any other medical conditions, including a history of seizures, liver problems, kidney problems, heart problems (eg, heart failure, slow or irregular heartbeat), high blood pressure, stroke, bleeding problems, stomach or bowel bleeding, metabolism problems, allergies, pregnancy, or breast-feeding. Tell your doctor if you or a family member has a history of bipolar disorder (manic-depression), other mental or mood problems, suicidal thoughts or attempts, or alcohol or substance abuse. Tell your doctor if you are dehydrated, have low blood volume or low blood sodium levels, drink alcohol, or will be having electroconvulsive therapy (ECT). Tell your doctor if you have a condition or take medicine that may increase your risk for low potassium or magnesium levels. Check with your doctor if you are not sure if any of your conditions or medicines may increase this risk. USE OF THIS MEDICINE IS NOT RECOMMENDED if you have a certain type of irregular heartbeat (long QT syndrome), slow heartbeat, severe heart failure, a recent heart attack, or uncorrected low blood potassium or magnesium levels, unless your doctor tells you otherwise. Contact your doctor or pharmacist if you have any questions or concerns about using this medicine.