Fluoxetine-citalopram

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Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine
Citalopram
Type Antidepressant
Group SSRI
links
ATC-code N06AB04
Medscape Citalopram
PubChem 2771
PubMed Citalopram
Kompas (Dutch) citalopram
Wikipedia citalopram

Switch medication from fluoxetine to citalopram.[1] [2]

Nietinrijdenbord.png Stop fluoxetine
  • Gradually reduce dosage of fluoxetine 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.
Eenrichtingbord.png Start citalopram
  • No wash-out period is needed.
  • Day 1: start citalopram/escitalopram the next day in low dosage of 10 mg/day, resp. 5 mg/day.
  • Day 14: increase dosage of citalopram/escitalopram to normal, i.e. 20 mg/day, resp. 10 mg/day.
Infobord.png More information
  • Fluoxetine has a very long elimination time; phasing out fluoxetine is therefore not necessary.
  • Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
  • Fluoxetine inhibits CYP2C19, CYP2D6 and CYP3A4, which metabolize (es)citalopram.
  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.
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