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    Patients should be cautioned about the risk of sertraline sex problems syndrome with the concomitant use of PROZAC and other serotonergic agents including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John's Wort see Contraindications 4. Warnings and Precautions 5."Generic drugs are being tested more carefully, and manufacturing standards are tighter than they were 10 years ago, he says.

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