When depression occurs, there may be a decreased amount of the chemicals noradrenaline and serotonin released from nerve cells in the brain. When these chemicals are released from nerve cells they act to lighten mood. When they are reabsorbed into the nerve cells, they no longer have an effect on mood.

Generic Desyrel works by preventing this re-absorption of serotonin back into the nerve cells.

Generic Desyrel may also act to mimic the mood-lightening effect of released serotonin and enhance a very small degree of noradrenaline release from nerve cells in the brain. Therefore, Generic Desyrel helps enhance and prolong the mood-lightening effect of any released noradrenaline and serotonin. This helps relieve depression.

Generic Desyrel also acts to relieve anxiety and is therefore useful in the treatment of depression that is accompanied by anxiety.

Generic Desyrel may also be used in the long-term treatment of anxiety disorders where other medication is considered inappropriate.

Adults
The usual starting dose of Generic Desyrel is 150 milligrams per day, divided into 2 or more smaller doses. Your doctor may increase your dose by 50 milligrams per day every 3 or 4 days. Total dose of Generic Desyrel should not exceed 400 milligrams per day, divided into smaller doses. Once you have responded well to Generic Desyrel, your doctor may gradually reduce your dose. Because Generic Desyrel makes you drowsy, your doctor may tell you to take the largest dose at bedtime.

Children
The safety and effectiveness of Generic Desyrel have not been established in children below 18 years of age.

If you miss a Generic Desyrel dose
If you miss a dose of Generic Desyrel, take it as soon as you can. If it is less than four hours to your next dose, take only that dose and skip the missed dose of Generic Desyrel. Do not take double or extra doses.

Generic Desyrel Overdose
Generic Desyrel overdose can cause serious consequences. Seek medical emergency immediately in case of overdose.

Symptoms of Generic Desyrel overdose include

• fainting
• chest pain
• convulsions
• difficulty in breathing (breathing may stop completely)
• irregular heart beat
• low heart rate
• low blood pressure
• drowsiness
• dizziness
• headache
• insomnia
• coma

Generic Desyrel Storage instructions
Keep Generic Desyrel out of the reach of children in a container that small children cannot open.
Store Generic Desyrel at room temperature approximately 25 degrees C or 77 degrees F. Avoid temperatures above 40 degrees C (104 degrees F). Protect from light. Keep container tightly closed. Throw away any unused amount of Generic Desyrel after the expiration date.

Generic Desyrel Preparations:
Tablets - 25 mg, 50 mg, 100 mg, 150 mg, 300 mg

If Generic Desyrel is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Generic Desyrel with the following:

• Antidepressant drugs known as MAO inhibitors, including Nardil and Parnate
• Barbiturates such as Seconal
• Central nervous system depressants such as Demerol and Halcion
• Chlorpromazine (Thorazine)
• Digoxin (Lanoxin)
• Drugs for high blood pressure such as Catapres and Wytensin
• Other antidepressants such as Prozac and Norpramin
• Phenytoin (Dilantin)
• Warfarin (Coumadin)

Treatment with Generic Desyrel should not be started until 2 weeks after stopping a MAOI. Conversely, a MAOI should not be started until one week after Generic Desyrel has been stopped.

Generic Desyrel precautions if you are pregnant or breastfeeding
There is no information available about the safety of Generic Desyrel during pregnancy, and Generic Desyrel should be avoided in the first trimester of pregnancy. Seek medical advice from your doctor.

There is no information available regarding the safety of Generic Desyrel during breastfeeding.

Special warnings about Generic Desyrel
You should not suddenly stop taking Generic Desyrel unless your doctor tells you otherwise.

Generic Desyrel may reduce your ability to drive or operate machinery safely. Do not drive or operate machinery until you know how Generic Desyrel affects you and you are sure it won\'t affect your performance.

If your erection lasts longer than 4 hours (priapism), consult a doctor immediately. Treatment of this condition should not be delayed more than 6 hours, as this can cause damage to the erectile tissue in the penis and irreversible erectile dysfunction.

Generic Desyrel may cause low blood sodium levels (hyponatraemia), which can result in drowsiness, confusion, muscle twitching or convulsions. Consult your doctor if you develop any of these symptoms while taking Generic Desyrel.

Visit your prescriber or health care professional for regular checks on your progress. You may have to take Generic Desyrel for two weeks or more before you feel better. If you have been taking Generic Desyrel for some time, do not suddenly stop taking it. Your prescriber or health care professional may want you to gradually reduce the dose; ask for advice.

You may get drowsy, dizzy or have blurred vision. Do not drive, use machinery, or do anything that needs mental alertness until you know how Generic Desyrel affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may increase dizziness or drowsiness; avoid alcoholic drinks.

Generic Desyrel can make your mouth dry. Chewing sugarless gum, sucking hard candy and drinking plenty of water will help.

Do not treat yourself for coughs, colds, or allergies without asking your prescriber or health care professional for advice. Some ingredients may increase possible side effects.

If you are going to have surgery, tell your prescriber or health care professional that you are taking Generic Desyrel.

If you feel you have experienced an allergic reaction, stop using Generic Desyrel and inform your doctor or pharmacist immediately.

Possible Generic Desyrel Side effects
More common side effects of Generic Desyrel may include:

• abdominal or stomach disorder,
• aches or pains in muscles and bones,
• anger or hostility,
• blurred vision,
• brief loss of consciousness,
• confusion, constipation,
• decreased appetite,
• diarrhea,
• dizziness or light-headedness,
• drowsiness,
• dry mouth,
• excitement,
• fainting,
• fast or fluttery heartbeat,
• fatigue,
• fluid retention and swelling,
• headache,
• inability to fall or stay asleep,
• low blood pressure,
• nasal or sinus congestion,
• nausea,
• nervousness,
• nightmares or vivid dreams,
• tremors,
• uncoordinated movements,
• vomiting,
• weight gain or loss

Less common side effects of Generic Desyrel may include:

• allergic reactions,
• anemia,
• bad taste in mouth,
• blood in the urine,
• chest pain,
• delayed urine flow,
• decreased concentration,
• decreased sex drive,
• disorientation,
• ejaculation problems,
• excess salivation,
• gas,
• general feeling of illness,
• hallucinations or delusions,
• high blood pressure,
• impaired memory,
• impaired speech,
• impotence,
• increased appetite,
• increased sex drive,
• menstrual problems,
• more frequent urination,
• muscle twitches,
• numbness,
• prolonged erections,
• red, tired, itchy eyes,
• restlessness,
• ringing in the ears,
• shortness of breath,
• sweating or clammy skin,
• tingling or pins and needles