Switch medication from citalopram to fluoxetine.
- Gradually reduce dosage of citalopram to a maximum of 20 mg/day, when this dosage is > 20 mg/day.
- When a dosage of 20 mg/day is reached, stop administration.
- No wash-out period is needed.
- Start fluoxetine the next day in normal dosage of 20 mg/day.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Fluoxetine slows the metabolism of citalopram by inhibition of CYP2C19, CYP2D6 and CYP3A4
- This switch is currently being reviewed.
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