Psychiatry Services

Venlafaxine/XR (Effexor®) Nefazodone (Serzone®)
Trazodone (Desyrel®) Bupropion/SR (Wellbutrin®)
Mirtazapine (Remeron®)

Course of Treatment: ___________________________________________________________________________________

Wellbutrin is currently being used in smoking cessation programs.

Uplifted mood and decreased feelings of sadness and anxiety or feelings of wanting to harm oneself.

Improved sleep and relief of insomnia or restlessness.

Increased energy, interest, and willingness to participate in activities.

Improved appetite.

Increased concentration and memory.

Decreased feelings of guilt.

If you elect to not take this medication, it is important for you to understand the potential consequences. The symptoms of depression will not get better; in fact, they could worsen.

When suffering from the symptoms of depression, you may have difficulty with your job, or relationships with family and friends, or day-to-day functioning.

Left untreated, depression could lead to suicidal thoughts or attempts.

Psychotherapy in combination with medication.

Other classes of antidepressant medication.

Electroconvulsive therapy.

Take with food to lessen stomach upset.

Store away from heat and direct light. Keep out of the reach of children. Do not store in the bathroom medicine cabinet since heat and moisture may cause medicine to break down.

Do not keep outdated medicine.

Consult with your physician regarding what to do if you miss a dose of scheduled medication.

Although side effects from this medication are not common, they may develop.

Nausea, dizziness, somnolence, or insomnia is sometimes associated with this medication. If these effects become especially troublesome, discuss them with your physician.

An increase in blood pressure may be observed with venlafaxine XR at higher doses. Therefore, it is important that you have your blood pressure monitored periodically while taking this medication.

Dizziness may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Other side effects may occur that usually does not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following continue or are bothersome:

Dry Mouth Nervousness

Constipation Anorexia

Tremor

Although side effects from this medication are not common, they may develop.

Anxiety, nervousness, or insomnia are sometimes associated with this medication. These effects usually go away after taking bupropion for a few days. If any of these effects persist or become especially troublesome, contact your physician. Your dose may need to be adjusted, and your doctor may prescribe an additional medication for insomnia and nervousness.

Seizures: Seizures may be of greater risk for patients with a history of serious head trauma, seizure disorder, or bulimia (an eating disorder). Tell your physician if you have any of these conditions before taking this medication. Use of this medication, especially in combination with alcohol, increases the risk of developing seizures. Therefore, avoid alcohol completely while taking this medication.

Altered appetite and weight changes occur in some patients. Your physician may want you to keep a record of your weight and daily food intake while taking this medication.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Drowsiness occurs less commonly with this medication. If this is a problem, be very cautious if driving or performing tasks that require alertness or coordination.

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following continue or are bothersome:

Swelling of hands or feet Loss of coordination

New emotional difficulties Frequent urination

Changes in sex drive or ability Hallucinations

Mouth sores Skin rash

Agitation Trembling

Flu-like symptoms

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Although side effects from this medication are not common, they may develop.

Dizziness, lightheadedness, or fainting may occur, especially when you get up from a lying or sitting position. Getting up slowly may help. If this problem continues or gets worse, check with your doctor.

Drowsiness - this is usually a problem only during the first few days when you start taking the medication. If this is a problem, be very cautious if driving or performing tasks that require alertness or coordination.

Sexual - if you notice changes in sexual desire or changes in sexual ability, notify your physician. Trazodone has been associated with prolonged painful erection. If you have a prolonged erection, seek immediate medical attention.

Although side effects from this medication are not common, they may develop.

While taking this medication, it is extremely important to inform your physician of all other medications you are taking, both over-the-counter as well as prescription medications. If nefazodone is taken with certain medications, it may increase their amounts in your bloodstream. Medications that should be avoided include: terfenadine (Seldane®), astemizole (Hismanal®), cisapride (Propulcid®), alprazolam (Xanax®), and triazolam (Halcion®). Grapefruit juice can also contains substances that can increase the effects of this medication, and it should also be avoided.

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following continue or are bothersome:

Nausea Dizziness Weakness

Insomnia Agitation

Although side effects from this medication are not common, they may develop.

Drowsiness—may be a problem. Make sure you know how you react to this medicine before you drive or use machinery, or do other jobs that may require you to be alert.

Dizziness, light-headedness, or fainting may occur, especially when you get up from a sitting position. Getting up slowly may help. If this problem gets worse, contact your physician.

Increased appetite and weight changes occur in some patients. Your physician my want you to keep a record of your weight and daily food intake while taking this medication. This medication may also cause an increase in your cholesterol or trigylcerides.

Dryness of mouth—use ice cubes, waters, sugarless candy to reduce dryness of secretions.

Constipation—increase in fluids, increase in physical exercise, eat leafy vegetables or bran cereals, drink lemon juice in warm water; occasionally take milk of magnesia or other mild laxative if suggested by your doctor.

Mirtazapine should not be taken with NAO inhibitors (Phenelzine, Tranylcypromine) or sooner than 144 days after stopping a MAO Inhibitor. To do so may increase change of serious side effects.

Any side effects of mouth sores, sore throat, chills or fever should be reported to your physician immediately.

Do not drink alcoholic beverages while taking antidepressants.

Do not stop taking this medication before checking with your doctor. Because people respond to medicines in very individual ways, you and your physician may have to go through a trial period to find the right drug and dosage that work best for you.

Before taking this medication, tell your physician what prescription and non-prescription medications you are taking (or have taken in the last two weeks). Do not begin taking prescription or non-prescription medication without consulting your physician.

Female patients: notify your doctor if you think you are pregnant, if you want to become pregnant, or if you are breastfeeding while taking this medication.

If you have questions or concerns regarding this medication, your physician may be reached at one of the following locations:

University Hospital
Psychiatric Unit
4502 Medical Drive
San Antonio, TX 78229
(210) 358-1260

University Health Center Downtown
Psychiatry Services - West Annex
1115 West Martin
San Antonio, TX 78207
(210) 358-3730

A pharmacist is also available to answer questions about your medication, and your prescription for this medication may be refilled at the following locations:

University Hospital Outpatient Pharmacy
4502 Medical Drive
San Antonio, TX 78229

Refill Line: (210) 358-4186
Pharmacist Line: (210) 358-2905

(Pharmacist available 24 hours every day.)
Outpatient Pharmacy Hours: 9:00 a.m. to 8:00 p.m. M-F
Weekend & Holidays: 9:00 a.m. to 5:00 p.m.

University Health Center Downtown Pharmacy
527 N. Leona St.
San Antonio, TX 78207

Refill Line: (210) 358-3476 (Please call 24 hours in advance.)
Pharmacist Line: (210) 358-3466

Pharmacy Hours: Monday thru Friday: 8:00 a.m. to 8:00 p.m.
Weekends and Holidays: Closed Saturday 8:30 a.m. – 4:00 p.m.

University Family Health Center, Southeast Pharmacy
3819 S. Gevers
San Antonio, TX 78223
(210) 358-5534-RPH

Refill Line: (210) 358-5535

Pharmacy Hours: 8:30 a.m.-7:00 p.m. Mon-Thurs
8:30 a.m.- 5:00 p.m. Fri.
8:00 a.m – 12:00 p.m. Sat
Closed on Sundays

University Family Health Center, Southwest Pharmacy
2121 SW 36th St.
San Antonio, TX 78237

(210) 358-5137-RPH
Refill Line: (210) 358-5138

Pharmacy Hours: 8:30 a.m. – 5:30 p.m. Mon. – Thurs.
8:30 a.m. through 5:00 p.m. Fri.
Closed Weekends & Holidays

PLEASE BE PREPARED TO PROVIDE YOUR NAME, PHONE NUMBER, HEALTH SYSTEM, I.D. NUMBER, AND Rx NUMBERS (S).