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Antidepressants, such as Fetzima (levomilnacipran), are prescribed to treat depression and other mental health conditions. While these medications can offer significant benefits, it is essential to be aware of potential risks and necessary precautions. Below is critical safety information to consider:

• Suicidal Thoughts and Behavior: Some individuals, particularly those aged 24 and younger, may experience an increased risk of suicidal thoughts or behaviors when beginning antidepressants or adjusting dosage. It is crucial to monitor for new or worsening depression and any unusual mood or behavior changes, especially in the initial months of treatment. Report any such changes to a healthcare provider immediately.

• Serotonin Syndrome: This rare but serious condition can occur due to excessive serotonin in the brain. Symptoms include rapid heart rate, sweating, muscle stiffness, fever, and confusion. If these symptoms appear, seek medical attention promptly. The risk increases if taking other medications that affect serotonin levels.

• Blood Pressure and Heart Rate: Fetzima may cause increased blood pressure and heart rate. Regular monitoring is advised, and any persistent elevation should be reported to a healthcare provider to consider alternative treatments, especially for those with a history of heart issues.

• Withdrawal Symptoms: Abruptly stopping Fetzima can lead to withdrawal symptoms, such as nausea, anxiety, and dizziness. To avoid these, consult with a healthcare provider to gradually reduce the dosage safely.

• Increased Bleeding Risk: The risk of bleeding or bruising may be heightened, especially if taking blood thinners or NSAIDs. Notify a healthcare provider about any unusual bleeding or bruising. Dose adjustments may be necessary for those on blood-thinning medications.

• Low Sodium Levels: Fetzima may lead to low sodium levels in the blood, particularly in older adults or those on diuretics. Symptoms like weakness, confusion, and memory problems should be reported to a healthcare provider immediately.

Always discuss any pre-existing conditions or concerns with a healthcare provider before starting or adjusting the dose of antidepressants. In case of an overdose or severe reactions, seek emergency medical assistance without delay.

When taking this medication, you may experience some common side effects like nausea, constipation, increased sweating, dizziness, and nose bleeds. These are generally mild, but if they persist or worsen, it's important to consult your healthcare provider. Other side effects may also include stomach pain, gas, dry eyes, dry skin, itching, yawning, and migraine. Again, while these effects can be bothersome, they are typically not serious.

It's crucial to be aware of more serious side effects that require immediate medical attention. These include symptoms of serotonin syndrome such as a fast heart rate, high fever, sweating, muscle stiffness, or spasms. If you experience unusual mood changes, suicidal thoughts or behaviors, or signs of an allergic reaction like rash or swelling of the face, tongue, or throat, seek urgent care. Other serious concerns include blurred vision or changes in vision, chest pain, seizures, shortness of breath, or symptoms of low sodium like confusion or memory problems.

Additionally, this medication can sometimes cause elevated blood pressure, so regular monitoring is recommended. In rare cases, serious conditions such as serotonin syndrome or severe allergic reactions can occur, especially when combined with other drugs that increase serotonin. It's important to inform your healthcare provider of all the medications you are taking to prevent these interactions. Always seek medical help if you notice any severe or unusual symptoms.

When taking Fetzima (levomilnacipran), be aware that it can interact with various medications and supplements. It is essential to inform your doctor and pharmacist about all the medications and supplements you are currently using, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Certain interactions are significant. For example, combining Fetzima with MAO inhibitors (such as isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, or tranylcypromine) can lead to serious, potentially fatal reactions. It's critical to avoid using these inhibitors during treatment and generally not for two weeks before and one week after stopping Fetzima.

Additionally, Fetzima should not be used with medications similar to milnacipran due to the risk of overlapping effects.

There are other drugs that may increase the risk of bleeding or serotonin syndrome when taken with Fetzima. These include, but are not limited to, certain antiplatelet drugs (like clopidogrel), NSAIDs (such as ibuprofen and naproxen), blood thinners (like dabigatran and warfarin), and various antidepressants (such as SSRIs like fluoxetine and SNRIs like duloxetine), as well as street drugs like MDMA. The risk is especially heightened when starting or increasing the doses of these medications.

Aspirin can increase the bleeding risk when used with Fetzima. However, if your doctor has advised taking low-dose aspirin for heart attack or stroke prevention, continue as instructed unless told otherwise.

Always consult your healthcare provider for guidance specific to your health condition and medication regimen.