Difference between revisions of "Fluoxetine-doxepine"
From Psychiatrienet
| Line 2: | Line 2: | ||
| from = fluoxetine | | from = fluoxetine | ||
| to = doxepin | | to = doxepin | ||
| − | | stop = | + | |stop = |
{{stopFluoxetine1}} | {{stopFluoxetine1}} | ||
| − | | start = | + | |start = |
Caution is necessary for at least four weeks. | Caution is necessary for at least four weeks. | ||
* '''Day 2:''' start administration of doxepin in a low dosage of 25 mg/day. | * '''Day 2:''' start administration of doxepin in a low dosage of 25 mg/day. | ||
| Line 13: | Line 13: | ||
* Fluoxetine and norfluoxetine slow the metabolism of doxepin via CYP2D6. | * Fluoxetine and norfluoxetine slow the metabolism of doxepin via CYP2D6. | ||
{{longt1/2fluvox}} | {{longt1/2fluvox}} | ||
| − | * Start low, go slow for doxepin. | + | * Start low, go slow for doxepin.}} |
Latest revision as of 13:44, 28 October 2015
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Switch medication from fluoxetine to doxepin.[2] [3]
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 doxepinCaution is necessary for at least four weeks.
- Day 2: start administration of doxepin in a low dosage of 25 mg/day.
- Day 15: increase dosage of doxepin to 50 mg/day.
- Day 29: increase dosage of doxepin to 75 mg/day.
More information- Fluoxetine and norfluoxetine slow the metabolism of doxepin via CYP2D6.
- Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
- Start low, go slow for doxepin.
- ↑ 1.0 1.1 1.2 1.3 1.4 KNMP; Informatorium Medicamentorum 2023; Monografie "doxepine" (Dutch)
- ↑ 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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