depression initial: 10 mg PO once daily; consider 5 mg once daily in very anxious or medication-sensitive patients.
depression titration: Increase by 10 mg/day after at least 1 week if needed and tolerated.
depression max: 20 mg/day per labeling; some clinicians cautiously use up to 30 mg/day with ECG monitoring in selected patients.
gad initial: 5–10 mg PO once daily.
gad titration: Increase by 5–10 mg/day at intervals of at least 1 week based on response and tolerability.
gad max: 20 mg/day.
ocd initial: 10 mg PO once daily.
ocd titration: Increase by 10 mg/day every 1–2 weeks as tolerated.
ocd max: Up to 40 mg/day off-label in refractory cases, with careful monitoring for QTc changes and side effects.
panic initial: 5 mg PO once daily for 3–7 days to reduce activation.
panic titration: Increase to 10 mg/day, then up to 20 mg/day after at least 1 week if needed.
panic max: 20 mg/day typical; higher doses rarely used and should be specialist-managed.
ptsd initial: 10 mg PO once daily.
ptsd titration: Increase by 5–10 mg/day every 1–4 weeks based on response and tolerability.
ptsd max: 20–40 mg/day off-label, with ECG monitoring at higher doses.
social anxiety initial: 5–10 mg PO once daily.
social anxiety titration: Increase to 20 mg/day after at least 4 weeks if partial response.
pmdd continuous: 5–10 mg PO once daily, increasing to 20 mg/day over the first month if needed.
pmdd luteal phase: 5–10 mg PO once daily, starting about 14 days before menses and stopping at onset of bleeding; may increase to 20 mg/day in the luteal phase.
pmdd symptom onset: 5–10 mg PO once daily from onset of symptoms until a few days after menses starts; may increase to 20 mg/day if needed.
premature ejaculation initial: 10 mg PO once daily.
premature ejaculation max: 20 mg PO once daily after 3–4 weeks if needed and tolerated.
vasomotor initial: 10 mg PO once daily for menopausal hot flashes.
vasomotor max: Increase to 20 mg/day after about 4 weeks if symptoms are not adequately controlled and tolerated.