Switch medication from fluoxetine to mianserine.
- 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.
No wash-out period is needed.
- Day 1: start mianserine the next day in low dosage of 30 mg/day.
- Day 21: increase dosage of mianserine to normal, 60 mg/day.
- (Desmethyl)Fluoxetine has a very long elimination time; phasing out fluoxetine is therefore not necessary.
- Fluoxetine slows the metabolism of mianserine through CYP2D6.
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