Fluvoxamine-nortriptyline

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Fluvoxamine
Type Antidepressant
Group SSRI
links
Medscape Fluvoxamine
PubChem 5324346
PubMed Fluvoxamine
Kompas (Dutch) Fluvoxamine
Wikipedia Fluvoxamine
Nortriptyline
Type Antidepressant
Group TCA
links
Medscape Nortriptyline
PubChem 4543
PubMed Nortriptyline
Kompas (Dutch) Nortriptyline
Wikipedia Nortriptyline

Switch medication from fluvoxamine to nortriptyline.[1] [2]

Nietinrijdenbord.png Stop fluvoxamine
  • Before day 1: gradually reduce dosage of fluvoxamine to a maximum of 50 mg/ day when this dosage is > 50 mg/day.
  • Day 1: reduce dosage of fluvoxamine to a maximum of 25 mg/day.
Eenrichtingbord.png Start nortriptyline

Caution is necessary.

  • Day 1: simultaneously start administration of nortriptyline in a low dosage of 25 mg/day.
  • Day 8: stop administration of fluvoxamine and continue administration of nortriptyline in a dosage of 50 mg/day.
Infobord.png More information
  • Fluvoxamine slows the metabolism of nortriptyline via CYP2D6.
  • "Start low, go slow" is not required, but caution is necessary.
  • This switch is currently being reviewed.
  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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