Difference between revisions of "Amitriptyline-fluoxetine"

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| to = fluoxetine  
 
| to = fluoxetine  
 
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| stop =  
{{stopAmitriptyline1}}
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{{stopAmitriptyline}}
 
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| start =  
* '''Day 8:''' start administration of fluoxetine in a normal dosage of 20 mg/day.
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* '''Day 9:''' start administration of fluoxetine in a normal dosage of 20 mg/day.
* '''Day 15:''' if necessary, increase dosage of fluoxetine.
+
* '''Day 16:''' if necessary, increase dosage of fluoxetine.
 
| info =  
 
| info =  
 
*{{theorSS}}
 
*{{theorSS}}
 
* Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong) and CYP3A4 (moderate), which metabolize amitriptyline.
 
* Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong) and CYP3A4 (moderate), which metabolize amitriptyline.
 
}}
 
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Revision as of 12:53, 2 November 2015

Amitriptyline
Type Antidepressant
Group TCA
links
ATC-code N06AA09
Medscape Amitriptyline
PubChem 2160
PubMed Amitriptyline
Kompas (Dutch) Amitriptyline
Wikipedia Amitriptyline
Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine

Switch medication from amitriptyline to fluoxetine.[1] [2]

Nietinrijdenbord.png Stop amitriptyline
  • Before day 1: gradually reduce dosage of amitriptyline to a maximum of 50-100 mg/ day, when this dosage is > 100 mg/day.
  • Day 1-3: reduce dosage of amitriptyline to 50 mg/day.
  • Day 4-7: reduce dosage of amitriptyline to 25 mg/day.
  • Day 8: stop administration of amitriptyline.
Eenrichtingbord.png Start fluoxetine
  • Day 9: start administration of fluoxetine in a normal dosage of 20 mg/day.
  • Day 16: if necessary, increase dosage of fluoxetine.
Infobord.png More information
  • Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
  • Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong) and CYP3A4 (moderate), which metabolize amitriptyline.
  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.
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