Fluvoxamine-vortioxetine

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Fluvoxamine
Type Antidepressant
Group SSRI
links
Medscape Fluvoxamine
PubChem 5324346
PubMed Fluvoxamine
Kompas (Dutch) Fluvoxamine
Wikipedia Fluvoxamine
Vortioxetine
Type Antidepressant
Group SMS
links
Medscape Vortioxetine
PubChem 9966051
PubMed Vortioxetine
Kompas (Dutch) Vortioxetine
Wikipedia Vortioxetine

Switch medication from fluvoxamine to vortioxetine.[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: when a dosage of 50 mg/day is reached, stop administration
Eenrichtingbord.png Start vortioxetine
  • A wash-out period is not necessary, but care is needed.
  • Day 1: start administration of vortioxetine in a dosage of 10 mg/day.
Infobord.png More information
  • Fluvoxamine is a strong inhibitor of CYP2C9, 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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