mdd initial: 50 mg PO once daily
mdd titration: Increase by 25–50 mg/day no more than once weekly based on response and tolerability
mdd max: 200 mg/day (labeling); some clinical practice uses up to 300 mg/day with specialist oversight
ocd initial: 50 mg PO once daily
ocd titration: Increase by 25–50 mg/day no more than once weekly based on response and tolerability
ocd max: 200 mg/day (labeling); some people who have not responded well enough may benefit from doses up to 400 mg/day, but side effects may increase
panic initial: 25 mg PO once daily for 3–7 days, then increase to 50 mg/day
panic titration: Increase by 25–50 mg at intervals of at least 1 week based on response and tolerability
panic max: 200 mg/day
ptsd initial: 25–50 mg PO once daily
ptsd titration: Increase by 25–50 mg at intervals of at least 1 week based on response and tolerability
ptsd max: 200 mg/day (labeling); some clinical practice uses up to 250 mg/day
social anxiety initial: 25–50 mg PO once daily
social anxiety titration: After 4–6 weeks at a lower dose, increase by 25–50 mg at intervals of at least 1 week as needed
social anxiety max: 200 mg/day (labeling); some clinical practice uses up to 250 mg/day
pmdd continuous initial: 25 mg PO once daily; increase to 50 mg/day over the first month as needed
pmdd continuous max: 200 mg/day
pmdd luteal phase initial: 25 mg PO once daily during luteal phase only (start 14 days before expected menses; stop at onset of menses); may increase to 50 mg/day over the first month
pmdd luteal phase max: 150 mg/day during luteal phase
pmdd symptom onset initial: 25 mg PO once daily starting on the day symptoms begin and continue until a few days after menses starts; may increase to 50 mg/day over the first month
pmdd symptom onset max: 150 mg/day during dosing window
gad initial: 25–50 mg PO once daily
gad titration: Increase by 25–50 mg/day at intervals of at least 1 week based on response and tolerability (in inpatient settings, may increase every 3–4 days if warranted)
gad max: 200 mg/day
binge eating initial: 25 mg PO once daily after lunch
binge eating titration: Increase by 25 mg every 3 days based on response and tolerability (some experts prefer slower titration of at least 1 week)
binge eating max: 200 mg/day
bdd initial: 50 mg PO once daily
bdd titration: Increase by 50 mg at intervals of every 2–3 weeks based on response and tolerability
bdd typical: 200 mg/day (often requires a 12–16 week trial; if using 200 mg, consider at least 4 weeks at 200 mg before judging response)
bdd max: Some people may need up to 400 mg/day if tolerated (specialist-level dosing because of side effect risk)
bulimia initial: 50 mg PO once daily
bulimia titration: Increase by 50 mg at intervals of at least 1 week based on response and tolerability
bulimia max: 300 mg/day (off-label, specialist-level dosing)
premature ejaculation daily: 50 mg PO once daily; increase by 50 mg about every 3–4 weeks as needed up to 200 mg/day
premature ejaculation on demand: 100 mg PO 6–8 hours before intercourse; maximum twice weekly with at least 3 days between doses
capsule use note: Do not initiate treatment with capsules. Use tablets or oral solution for initiation and titration and for doses under 150 mg/day. Capsules (150 mg or 200 mg) may be considered only after a patient has been stable on 100–125 mg/day for at least 1 week or on at least 150 mg/day.