Nortriptyline-paroxetine
From Psychiatrienet
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Switch medication from nortriptyline to paroxetine.[1] [2]
Stop nortriptyline - Before day 0: gradually reduce dosage of nortriptyline to a maximum of 50 mg/day.
- Day 1: reduce dosage of nortriptyline to 25 mg/day.
- Day 3: reduce dosage of nortriptyline to 10 mg/day.
Start paroxetine- Day 1: simultaneously start administration of paroxetine in a low dosage of 10 mg/day.
- Day 8: stop administration of nortriptyline and continue administration of paroxetine in a dosage of 20 mg/day.
More information- Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
- Paroxetine is a strong inhibitor of CYP2D6, which metabolizes nortriptyline.
- ↑ 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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