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Antidepressant medications play a vital role in treating depression and various mental or mood disorders. They can significantly reduce the risk of suicidal thoughts or attempts and offer multiple other benefits. However, research indicates that a small subset of individuals, particularly those under 25, may experience an increase in depression, altered mental or mood symptoms, or suicidal thoughts/attempts when using these medications. It is crucial to discuss with a healthcare provider the potential risks and advantages of taking antidepressants, especially for those under 25 and even if the medication is prescribed for non-mental/mood conditions.

• Immediately inform your doctor if there are any signs of worsening depression, other psychiatric symptoms, or unusual behavioral changes, such as suicidal thoughts or attempts.
• Be on the lookout for mental/mood changes, including new or worsening anxiety, panic attacks, sleep disturbances, irritability, hostility, impulsive actions, severe restlessness, or unusually rapid speech.
• Extra vigilance is required when initiating a new antidepressant or adjusting the dosage.

Maintaining open communication with your healthcare provider is essential to ensure the safe and effective use of antidepressant medications.

While taking this medication, you might experience some common side effects such as constipation, vomiting, increased sweating, dizziness, or nosebleeds. These side effects are generally mild, but if they persist or worsen, it is advisable to seek guidance from a healthcare professional. The medication may also cause an increase in blood pressure, so regular monitoring is recommended.

Some individuals may encounter more serious side effects, which need immediate attention. These include a pounding heartbeat, easy bleeding or bruising, decreased interest in sex, changes in sexual ability, difficulty initiating urination, and painful urination. Additionally, signs of low sodium levels like nausea, extreme drowsiness, or mood changes should also prompt a consultation with a medical professional.

Rarely, this medication can lead to severe side effects requiring urgent medical intervention. These include black stools, vomit resembling coffee grounds, seizures, eye pain, widened pupils, or vision changes like seeing rainbows around lights. Another rare but serious condition is serotonin syndrome, marked by symptoms such as a fast heartbeat, hallucinations, severe dizziness, or muscle twitching. It's important to be aware of these symptoms, especially if taking other drugs that increase serotonin levels.

Though very uncommon, serious allergic reactions can occur, presenting as a rash, itching, swelling of the face or throat, or difficulty breathing. Immediate medical help is crucial in such cases. Always inform your healthcare provider about any other medications you are using to prevent adverse interactions.

Some medications may interact with this drug. These include diuretics or "water pills" like furosemide, and medications that can lead to bleeding or bruising, such as antiplatelet drugs like clopidogrel, NSAIDs like ibuprofen or naproxen, and anticoagulants or "blood thinners" like dabigatran or warfarin. Using aspirin alongside this medication may raise the risk of bleeding. However, if your doctor has advised you to take low-dose aspirin for heart attack or stroke prevention (typically 81-162 milligrams daily), continue unless instructed otherwise by your doctor. For more information, consult your doctor or pharmacist.

Additionally, the risk of developing serotonin syndrome or toxicity is heightened if you are using other drugs that boost serotonin levels. This includes certain street drugs like MDMA or "ecstasy," St. John's wort, and some antidepressants such as SSRIs (e.g., fluoxetine, paroxetine) and SNRIs (e.g., duloxetine, venlafaxine). The likelihood of serotonin syndrome or toxicity may increase when starting or upping the dose of these medications.

A severe, potentially fatal interaction can occur if this medication is taken with MAO inhibitors. Avoid using MAO inhibitors (such as isocarboxazid, linezolid, metaxalone, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine) during treatment and generally for two weeks before and seven days after concluding this medication. Your doctor can guide you on when to begin or cease this medication.

Lastly, levomilnacipran is closely related to milnacipran, so avoid using milnacipran while taking levomilnacipran.