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Manic episodesracing thoughtsincreased energyunusual risk-taking behaviorextreme happinessbeing irritable or talkative.

1 Department of Psychiatry and Behavioral SciencesAlbert Einstein College of MedicineNew YorkNYUSA.

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Tell the doctor right away if you notice worsening depression/other psychiatric conditionsunusual behavior changesincluding possible suicidal thoughts/attemptsor other mental/mood changesincluding new/worsening anxietypanic attackstrouble sleepingirritabilityhostile/angry feelingsimpulsive actionssevere restlessnessvery rapid speechBe especially watchful for these symptoms when a new antidepressant is started or when the dose is changed.

Do not use EMSAM if youtake certain medicines includingselective serotonin reuptake inhibitorsSSRIssuch as fluoxetinesertralineor paroxetineserotonin and norepinephrine reuptake inhibitorsSNRIsuch as venlafaxine or duloxetineclomipramine or imipraminetricyclic antidepressantsmeperidinetramadolmethadonepentazocinepropoxypheneopioid medicinesdextromethorphanor carbamazepine are less than 12 years of age have a tumor on your adrenal gland called a pheochromocytoma Ask your health care professional or pharmacist if you are not sure if you take these medicines.

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