1. Pre-treatment work-up should include an assessment of renal and hepatic function, since both are involved in its excretion. There are, however, no data on its use in patients with renal or hepatic impairment.
2. The initial dosage is 25 mg qd, increased weekly to 50 mg/day, 100 mg/day, then 200 mg/day. Up to 400 mg may be required to treat depression. Dosing can be either once or twice a day.
3. Serum levels are not clinically relevant since there is no available information regarding a therapeutic window.
4. Coadministration with other anticonvulsants can affect serum levels and should be used with caution.
5. Therapeutic effect may be seen in 2-4 weeks.
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