Fluoxetine-escitalopram
From Psychiatrienet
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Switch medication from fluoxetine to escitalopram.[1] [2]
Stop fluoxetine - Day 1: Stop fluoxetine
Start escitalopram- Day 5: Start with 50% of the target dose
- Day 10: Increase dose to 100% of the target dose
- Day 11 and after: Gradually increase dose as necessary
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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