Difference between revisions of "Duloxetine-vortioxetine"

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* Duloxetine is a strong inhibitor of CYP2D6, which metabolizes vortioxetine.  
 
* Duloxetine is a strong inhibitor of CYP2D6, which metabolizes vortioxetine.  
 
* Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
 
* Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
 +
* Patients could be directly switched from a SSRI or a SNRI to vortioxetine 10 mg/day. One week after initiation with vortioxetine, the dosage could be increased from 10 mg/day to 20 mg/day.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/25087600 Montgomery SA et al. A randomised, double-blind study in adults with major depressive disorder with an inadequate response to a single course of selective serotonin reuptake inhibitor or serotonin-noradrenaline reuptake inhibitor treatment switched to vortioxetine or agomelatine. Hum Psychopharmacol. 2014 Sep;29(5):470-82.]</ref>
 
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Revision as of 16:49, 4 March 2015

Duloxetine
Type Antidepressant
Group SNRI
links
Medscape Duloxetine
PubChem 60835
PubMed Duloxetine
Kompas (Dutch) Duloxetine
Wikipedia Duloxetine
Vortioxetine
Type Antidepressant
Group SMS
links
Medscape Vortioxetine
PubChem 9966051
PubMed Vortioxetine
Kompas (Dutch) Vortioxetine
Wikipedia Vortioxetine

Switch medication from duloxetine to vortioxetine.[1] [2]

Nietinrijdenbord.png Stop duloxetine
  • Before day 1: gradually reduce dosage of duloxetine to a maximum of 60 mg/day, when this dosage is > 60 mg/day.
  • Day 1-7: reduce dosage of duloxetine from 60 mg/day to 30 mg/day
  • Day 8-14: reduce dosage of duloxetine to 30 mg/day to 0 mg/day
  • Day 15: stop administration of duloxetine.
Eenrichtingbord.png Start vortioxetine
  • A wash-out period is not necessary, but care is needed.
  • Day 15: Start administration of vortioxetine in a dosage of 10 mg/day.
Infobord.png More information
  • Duloxetine is a strong inhibitor of CYP2D6, which metabolizes vortioxetine.
  • Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
  • Patients could be directly switched from a SSRI or a SNRI to vortioxetine 10 mg/day. One week after initiation with vortioxetine, the dosage could be increased from 10 mg/day to 20 mg/day.[3]
  1. Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
  2. Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
  3. Montgomery SA et al. A randomised, double-blind study in adults with major depressive disorder with an inadequate response to a single course of selective serotonin reuptake inhibitor or serotonin-noradrenaline reuptake inhibitor treatment switched to vortioxetine or agomelatine. Hum Psychopharmacol. 2014 Sep;29(5):470-82.
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