The drug was taken for 14 days premenstrually for only three menstrual cycles. Stamford, Conn.: Appleton & Lange, 1999;1154–5Fluoxetine may be an appropriate antidepressant choice in patients with hypersomnia or psychomotor retardation and should probably be avoided in patients with concomitant anxiety, panic, and agitation.3Sertraline (Zoloft) is begun at a dosage of 50 mg per day and titrated to a dosage range of 100 to 200 mg per day in a single daily dose or divided daily doses12 .Seventy-five percent of the women reported significant improvement in premenstrual symptoms. In elderly patients or patients with concomitant anxiety disorders, a starting dose of 25 mg per day is recommended.Augmentation with lithium or triiodothyronine may be useful in patients who are partially or totally resistant to antidepressant treatment.

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The choice of antidepressant drug depends on the agent's pharmacologic profile, secondary actions, and tolerability.

Sexual dysfunction related to the use of antidepressants may be addressed by reducing the dosage, switching to another agent, or adding another drug to overcome the sexual side effects.

It is the only SSRI that is FDA-approved specifically for the treatment of depression in patients who are 65 years of age or older.6 A starting dose of 10 mg per day is preferred in elderly patients, with subsequent titration to 20 mg per day or more.

Dosages of 20 to 40 mg per day are commonly required for the treatment of depression; 60 to 80 mg per day may be necessary for the treatment of bulimia and OCD7 .

Prozac Weekly is a capsule with pellets containing 90 mg of fluoxetine hydrochloride.

The enteric coating prevents dissolution of the pellets until they have passed into the portion of the gastrointestinal tract where the p H exceeds 5.5.6 In a study8 of 500 patients with depression, the percentage of patients relapsing during continuation treatment with a 90-mg weekly dose was not significantly different from those taking a 20-mg daily dose. Weekly dosing is recommended to begin seven days after the last daily dose of 20 mg .The most common side effects of sertraline are nausea, dry mouth, fatigue, and decreased libido.Treatment with sertraline should be started at 50 mg, either daily throughout the month or daily during the luteal phase of the menstrual cycle.This article is an update of information about the newer agents for depression and new indications for older antidepressants.Selective serotonin reuptake inhibitors (SSRIs) have replaced tricyclic antidepressants as the drugs of choice in the treatment of depressive disorders, mainly because of their improved tolerability and safety if taken in overdose.The newest indication for sertraline is the treatment of PMDD.