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...uoxetine, causing increased CNS depressant.3 An alternative medication for the management of depression is velafaxine.1-4 It is one of many drugs for depression, but is the drug of choice for this patient due to the fact that there are no interactions between it and sibutramine. An alternative medication for the agitation-like symptoms including “muscle-shaking” is alprazolam.5 These two changes in medication work well, due to the fact that all three together are safe for the patient.1 Venlafaxine usual dosage is 75mg a day and can be divided into two or three doses. It should be taken with food. Some common side effects are headache, nausea, and dizziness.1,2,4,6 With Alprazolam, the usual dosage to help with the “muscle-shaking” or tremors is 0.5mg per day. Alprazolam can be taken with or without food. Some side effects that can occur while on the medication are drowsiness, fatigue, and sedation.5 After assessing the patient’s current medical conditions, and her current therapy, it is recommended that she be taken off of fluoxetine and add venlafaxine, and recommend alprazolam instead of valerian. Due to the adverse effects of fluoxetine and valerian with sibutramine led to the change in the dosing regimen. Venlafaxine is a proven anti-depressant and alprazolam is proven to ...