Review and information - ENDEP

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Endep belongs to the tricyclic antidepressants. The drug is mostly used to treat depression and obsessive compulsive disorder (OCD). The last is a nervous condition where a person has recurring thoughts or ideas, or does repetitive things because they are anxious.
Endep works on the central nervous system (CNS) and helps to relieve the symptoms of OCD. The medication helps to restore the balance of certain natural substances (serotonin, among others) in the brain. This medication is also used to treat panic attacks and ongoing pain.

Dosage and direction
Take the drug only as prescribed because dosage and schedule may vary on your condition and other factors.
It is advised to follow the doctor's instructions carefully and not to take more or less medication than prescribed.
It is advised not to eat grapefruit or drink grapefruit juice ( it influences the level of cyclosporin in your blood ). Also limit alcoholic beverages.
Do not suddenly stop taking this medication as your condition may become worse.
It may take 2 to 3 weeks or longer before you notice the effects of this medication. Inform your doctor about your condition.

Precautions
Before you start taking Endep, tell your doctor or pharmacist if you have any kind of allergy to drugs or food.
Inform your doctor or pharmacist if you have certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG). In patients with seizures Endep may cause them more severe. Cautiousness should be exercised in patients with glaucoma and prostate enlargement.
You may feel dizzy or drowsy or have temporary blurred vision. Avoid driving, using machinery, or doing any activity that requires alertness.
Aged people may be more sensitive to the side effects of the drug.
During pregnancy this medication should be used only if benefits of its use prevail over potential risk for mother and baby. Consult your doctor about the risks.
This medicine passes into breast milk so it may cause harm to a nursing infant. It is better to stop breast-feeding while using this drug.

Contraindications
The medication cannot be used in patients with hypersensitivity to the components of Endep, in patients during acute recovery phase of myocardial infarction, and in patients treated by MAO inhibitors.

Possible side effect
The most common side effects are dizziness, dry mouth, drowsiness, constipation, stomach upset, nausea, vomiting, sweating etc. Anxiety symptoms may temporarily worsen when you first start using Endep.
A serious allergic reaction to this drug is very rare, but seek immediate medical help if it occurs.
Many people using this medicine do not have serious side effects.
If you experience any side effects not listed above, notify your health care advisor or pharmacist.

Drug interaction
Tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use before using this medication.
Avoid taking Endep with:
* MAO inhibitors: Furazolidone, Isocarboxazid, Linezolid, Moclobemide Tranylcypromine, etc which cause high fever and convulsions if they are used together with Endep.
* anti-arrhythmic medication: Propafenone, Quinidine, etc.
* Epinephrine (stimulates alpha and beta receptors) concomitantly administered with Endep causes severe high blood pressure.
* Selective Serotonin Reuptake Inhibitors (SSRIs): Citalopram, Dapoxetine, Fluoxetine, Fluvoxamine, Paroxetine, etc.
* Antipsychotics (also called neuroleptics): Fluphenazine, etc.
* H2-receptor antagonists: Cimetidine, Ranitidine, Famotidine, Nizatidine, etc.
Nicotine decreases blood levels of this medication. Inform your doctor if you smoke or if you have recently stopped smoking.
Try not to eat grapefruit or drink grapefruit juice while being treated with this medication.
Consult your doctor or pharmacist for more details.

Missed dose
The missed dose should be taken as soon as you remember. If you see that it is near the time for the next intake, skip the missed dose and return to your usual dosing schedule. Do not take the dose twice.

Overdose
If you think you have used too much of this medicine seek emergency medical attention right away. The symptoms of overdose usually include nausea, chest pain, irregular heartbeat, and feeling light-headed or fainting.

Storage
Store your medicines at room temperature between 68-77 F (20-25 C) away from light and moisture. Do not store the drugs in the bathroom. Keep all drugs away from reach of children and pets.

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