Switch medication from paroxetine to maprotiline.
- Before day 1: gradually reduce dosage of paroxetine to a maximum of 20 mg/day when this dosage is > 20 mg/day.
- Day 1: reduce dosage of paroxetine to a maximum of 10 mg/day.
- Day 8: stop dosage of paroxetine.
Caution is necessary.
- Day 8: start administration of maprotiline in a low dosage of 25 mg/day.
- Day 15: increase administration of maprotiline to a dosage of 50-100 mg/day.
- "Start low, go slow" is not required, but caution is necessary!
- Paroxetine slows the metabolism of maprotiline via CYP1A2 and CYP2D6.
- This switch is currently being reviewed.
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