Contraindicated in:

• Hypersensitivity;

• Bone marrow depression;

• Severe CNS depression/coma;

• Uncontrolled epilepsy;

• Granulocytopenia;

• Lactation: Discontinue drug or bottle-feed.

• Long QT syndrome;

• Risk factors for QT interval prolongation or ventricular arrhythmias (i.e recent myocardial infarction, heart failure, arrhythmias);

• Concurrent use of CYP1A2, CYP2D6, or CYP3A4 inhibitors or QT-interval prolonging drugs;

• Hypokalemia or hypomagenesemia;

• Prostatic enlargement;

• Angle-closure glaucoma;

• Malnourished patients or patients with cardiovascular, hepatic, or renal disease (use lower initial dose, titrate more slowly);

• Risk factors for stroke (↑ risk of stroke in patients with dementia);

• Diabetes;

• Seizure disorder;

• OB: Neonates at ↑ risk for extrapyramidal symptoms and withdrawal after delivery when exposed during the 3rd trimester; use only if benefit outweighs risk to fetus;

• Pedi: Children <16 yr (safety not established);

• Geri: ↑ risk of mortality in elderly patients treated for dementia-related psychosis.