Dosing & Uses
8-12 g/d PO divided QID/TID
Lower dosage effective in combination with other antidepressants
Take with low-protein, carbohydrate-rich meals or snacks
Safety and efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Frequency Not Defined
Some bipolar pts are acutely sensitive & would not tolerate dosage >1-2 g/d
Clinical worsening & suicide ideation may occur despite medication
Pregnancy & Lactation
Pregnancy Category: C
Lactation: avoid during breastfeeding
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Metabolism: Converted to nicotinic acid & serotonin as well as incorporated into proteins
Mechanism of Action
Incr serotonin synthesis