Switch medication from sertraline to nortriptyline.
- Before day 1: gradually reduce dosage of sertraline to a maximum of 50 mg/ day when this dosage is > 50 mg/day.
- Day 1: reduce dosage of sertraline to a maximum of 25 mg/day.
- Day 1: simultaneously start administration of nortriptyline in a low dosage of 25 mg/day.
- Day 8: stop administration of sertraline and continue administration of nortriptyline in a dosage of 50 mg/day
- “Start low, go slow” is not required, but caution is necessary.
Sertraline dose-dependently slows the metabolism of nortriptyline via CYP2D6.
- This switch is currently being reviewed.
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