Difference between revisions of "Paroxetine-imipramine"

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(Created page with '{{Drugswitch | from = paroxetine | to = imipramine | stop = * '''Day 0:''' gradually reduce dosage of paroxetine to a maximum of 20 mg/day when this dosage is > 20 mg/day. * ...')
 
 
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| from = paroxetine  
 
| from = paroxetine  
 
| to = imipramine
 
| to = imipramine
| stop =  
+
| stop = {{StopSSRI,SNRI}}
* '''Day 0:''' 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:''' reduce dosage of paroxetine to 5 mg/day.
 
 
| start =  
 
| start =  
Caution is necessary.
+
* '''Day 1:''' start administration of imipramine in a low dosage of 25mg/day.  
* '''Day 8:''' simultaneously start administration of imipramine in a low dosage of 25 mg/day.  
+
* '''Day 8:''' increase dosage of imipramine to a dosage of 50 mg/day.
* '''Day 15:''' stop administration of paroxetine and only continue administration of imipramine in a dosage of 25-75 mg/day.
 
* Start low, go slow!
 
 
| info =  
 
| info =  
* Paroxetine slows the metabolism of imipramine via CYP1A2 and CYP2D6. }}
+
* Paroxetine slows the metabolism of imipramine via CYP2D6 inhibition.  
 +
* {{SSCYPinh}}
 +
* {{TCAplasmalevelmonitoring}}
 +
}}

Latest revision as of 14:33, 30 June 2023

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

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

Nietinrijdenbord.png Stop paroxetine
  • Day 1: Decrease dose to 50%
  • Day 8: Stop
Eenrichtingbord.png Start imipramine
  • Day 1: start administration of imipramine in a low dosage of 25mg/day.
  • Day 8: increase dosage of imipramine to a dosage of 50 mg/day.
Infobord.png More information
  • Paroxetine slows the metabolism of imipramine via CYP2D6 inhibition.
  • Due to CYP inhibition a longer period of time is needed to reach steady state concentration. Please keep in mind when monitoring plasma levels
  • Plasma monitoring for TCA's is advisable, because of plasma-reponse relations, genetic polymorphism and under or overdosing.[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. (dutch) monografie.org tricyclische-antidepressiva
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