Sorry for the late reply just came upon this. Formula is not that crazy but isn't always the right choice as always it depends on the patient. All the solutions have their own side effects from increased risk of bladder infection, cardiac compromise to Serotonin Syndrome so the patient's history needs to be considered and the best option used. The first time I had to do this I thought it was crazy too but I've seen adverse reactions to other solutions and would opt for a bladder infection especially if the patient is on antidepressants.