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Fluoxetine-vortioxetine

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* '''Before day 1:''' gradually reduce dosage of escitalopram to a maximum of 10 mg/day, when this dosage is  > 10 mg/day.  
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* '''Before day 1:''' reduce dosage of fluoxetine to 20 mg/day, when this dosage is  > 20 mg/day.  
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* '''Day 1:''' when a dosage of 10 mg/day is reached, stop administration
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* '''Day 1:''' stop administration
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* A wash-out period is not necessary, but care is needed.
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* '''Day 1-21:''' A wash-out period is needed.  
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* '''Day 1:''' start administration of vortioxetine in a dosage of 10 mg/day.
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* '''Day 22:''' Start vortioxetine in a dosage of 10 mg/day.
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| info =
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* '''After day 28 :''' If necessary, increase gradually the dosage of vortioxetine.
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* Fluoxetine is a strong inhibitor of CYP2D6, which metabolizes vortioxetine.
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* Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
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* Fluoxetine slows the metabolism of vortioxetine via CYP2D6, so caution is necessary for at least four weeks after stopping fluoxetine.
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* 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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* {{theorSS}
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Revision as of 13:23, 12 March 2015

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