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Patientstheir familiesand their caregivers should be encouraged to be alert to the emergence of anxietyagitationpanic attacksinsomniairritabilityhostilityaggressivenessimpulsivityakathisiapsychomotor restlessnesshypomaniamaniaother unusual changes in behaviorworsening of depressionand suicidal ideationespecially early during antidepressant treatment and when the dose is adjusted up or downFamilies and caregivers of patients should be advised to look for the emergence of such symptoms on a day-to-day basissince changes may be abruptSuch symptoms should be reported to the patient’s prescriber or health professionalespecially if they are severeabrupt in onsetor were not part of the patient’s presenting symptomsSymptoms such as these may be associated with an increased risk for suicidal thinking and behavior and indicate a need for very close monitoring and possibly changes in the medicationsee WARNINGS AND PRECAUTIONS
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