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Fluoxetine-imipramine

Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine
Imipramine
Type Antidepressant
Group TCA
links
Medscape Imipramine
PubChem 3696
PubMed Imipramine
Kompas (Dutch) Imipramine
Wikipedia Imipramine

Switch medication from fluoxetine to imipramine.

Nietinrijdenbord.png 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.
Eenrichtingbord.png Start imipramine

Caution is necessary for at least four weeks.

  • Day 2: start administration of imipramine in a low dosage of 25 mg/day.
  • Day 15: increase dosage of imipramine to 50 mg/day.
  • Day 29: gradually increase dosage of imipramine to 75 mg/day and more.
Infobord.png 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.
  • Fluoxetine and norfluoxetine slow the metabolism of imipramine via CYP2D6.
  • Start low, go slow for imipramine.
  • Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
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