Difference between revisions of "Fluoxetine-escitalopram"
From Psychiatrienet
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* '''Day 15''' increase dosage of escitalopram to normal, i.e. 10 mg/day. | * '''Day 15''' increase dosage of escitalopram to normal, i.e. 10 mg/day. | ||
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| − | {{longt1/ | + | {{longt1/2fluvox}} |
* {{theorSS}} | * {{theorSS}} | ||
* Fluoxetine inhibits CYP2C19, CYP2D6 and CYP3A4, which metabolize escitalopram. | * Fluoxetine inhibits CYP2C19, CYP2D6 and CYP3A4, which metabolize escitalopram. | ||
}} | }} | ||
Revision as of 11:30, 28 October 2015
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Switch medication from fluoxetine to escitalopram.[1] [2]
Stop fluoxetine - Before day 1: reduce dosage of fluoxetine with about 20 mg per week.
- Day 1: when a dosage of 20 mg/day is reached, stop fluoxetine.
Start escitalopram- No wash-out period is needed.
- Day 2: start escitalopram the next day in low dosage of 5 mg/day.
- Day 15 increase dosage of escitalopram to normal, i.e. 10 mg/day.
More information- Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Fluoxetine inhibits CYP2C19, CYP2D6 and CYP3A4, which metabolize escitalopram.
- ↑ 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
- ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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