Fluoxetine-imipramine

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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.[1] [2]

Nietinrijdenbord.png Stop fluoxetine
  • Gradually reduce dosage of fluoxetine to a maximum of 20 mg/ day, when this dosage is > 20 mg/day.
  • When a dosage of 20 mg/day is reached, stop administration.
Eenrichtingbord.png Start imipramine

Caution is necessary for at least four weeks.

  • Day 1: start administration of imipramine in a low dosage of 25 mg/day.
  • Day 14: increase dosage of imipramine to 50 mg/day.
  • Day 28: gradually increase dosage of imipramine to 75 mg/day and more.
Infobord.png More information
  • 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.
  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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