Switch medication from citalopram to tranylcypromine.
- Day 0: gradually reduce dosage of citalopram/escitalopram to a maximum of 20 mg/ day resp. 10 mg/day, when this dosage is respectively > 20 mg/day and > 10 mg/day.
- Day 1: Reduce dosage of citalopram/escitalopram to a maximum of 10 mg/ day resp. 5 mg/day.
- Day 8: stop administration of citalopram/escitalopram.
- Day 8-21: a wash-out period of two weeks is necessary.
- Day 22: Start administration of tranylcypromine in low dosage of 20 mg/day for one week.
- Day 29: after this week the dosage of tranylcypromine can be increased if necessary.
- Occurrence of serotonin syndrome is reported when a wash-out period (of two weeks) is not considered.
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