Switch medication from paroxetine to amitriptyline.
- Before day 1: gradually reduce dosage of paroxetine to a maximum of 20 mg/day when this dosage is > 20 mg/day.
- Day 1: reduce dosage of paroxetine to a maximum of 10 mg/day.
- Day 8: stop administration of paroxetine
- Day 8: start administration of amitriptyline in a low dosage of 25-50 mg/day.
- Day 15: if necessary increase dosage of amitriptyline to a dosage of 50-100 mg/day.
- Paroxetine slows the metabolism of amitriptyline via CYP2D6.
- This switch is currently being reviewed.
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