Patient/Family Teaching

• Instruct patient to take medication exactly as directed. Abrupt discontinuation may cause nausea, headache, and malaise

• May cause drowsiness and blurred vision. Caution patient to avoid driving and other activities requiring alertness until response to drug is known

• Orthostatic hypotension, sedation, and confusion are common during early therapy, especially in geriatric patients. Protect patient from falls and advise patient to change positions slowly

• Advise patient to avoid alcohol or other CNS depressant drugs during course of therapy and for 3–7 days after cessation of therapy

• Instruct patient to notify health care professional if dry mouth or constipation persists or if urinary retention, uncontrolled movements, or rigidity occurs. Sugarless candy or gum may diminish dry mouth, and an increase in fluid intake or bulk may prevent constipation. If these symptoms persist, dosage reduction or discontinuation may be necessary. Consult health care professional if dry mouth persists for more than 2 wk

• Advise patient to inform health care professional if sexual dysfunction occurs. Inform male patients that sexual dysfunction is common with this medication

• Caution patient to use sunscreen and protective clothing to prevent photosensitivity reactions

• Inform patient of need to monitor dietary intake because possible increase in appetite may lead to undesired weight gain

• Advise patient to notify health care professional of medication regimen before treatment or surgery

• Emphasize the importance of follow-up exams to monitor effectiveness and side effects and to improve coping skills

• Inform patients taking high doses (250–300 mg/day) that risk of seizures is increased

• Refer patient to local OCD group

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