Imipramine-paroxetine

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Imipramine
Type Antidepressant
Group TCA
links
Medscape Imipramine
PubChem 3696
PubMed Imipramine
Kompas (Dutch) Imipramine
Wikipedia Imipramine
paroxetine
Type Antidepressant
Group SSRI
links
Medscape paroxetine
PubChem 43815
PubMed paroxetine
Kompas (Dutch) paroxetine
Wikipedia paroxetine

Switch medication from imipramine to paroxetine.[1] [2]

Nietinrijdenbord.png Stop imipramine
  • Before day 1: gradually reduce dosage of imipramine to a maximum of 75 mg/ day, when this dosage is > 75 mg/day.
  • Day 1-3: reduce dosage of imipramine to 50 mg/day.
  • Day 4-7: reduce dosage of imipramine to 25 mg/day.
  • Day 8: stop administration of imipramine.
Eenrichtingbord.png Start paroxetine
  • Day 4: simultaneously start administration of paroxetine in a normal dosage of 20 mg/day.
  • Day 8: stop administration of imipramine and continue administration of paroxetine.
Infobord.png More information
  • Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
  • Paroxetine is a strong inhibitor of CYP2D6, which metabolizes imipramine.
  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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