Fluvoxamine-amitriptyline

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Fluvoxamine
Type Antidepressant
Group SSRI
links
Medscape Fluvoxamine
PubChem 5324346
PubMed Fluvoxamine
Kompas (Dutch) Fluvoxamine
Wikipedia Fluvoxamine
Amitriptyline
Type Antidepressant
Group TCA
links
ATC-code N06AA09
Medscape Amitriptyline
PubChem 2160
PubMed Amitriptyline
Kompas (Dutch) Amitriptyline
Wikipedia Amitriptyline

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

Nietinrijdenbord.png Stop fluvoxamine
  • Before day 1: gradually reduce dosage of fluvoxamine to a maximum of 100 mg/day when the dosage is > 100 mg/day.
  • Day 1: reduce dosage of fluvoxamine to a maximum of 50 mg/day.
  • Day 8: stop administration of fluvoxamine
Eenrichtingbord.png Start amitriptyline

Caution is necessary.

  • Day 1: simultaneously start administration of amitriptyline in a low dosage of 25 mg/day.
  • Day 8: continue administration of amitriptyline in a dosage of 50 mg/day.
  • Start low, go slow!
Infobord.png More information
  • Fluvoxamine is an inhibitor of CYP1A2, CYP2C19 and CYP3A4 (moderate), which metabolize amitriptyline.
  • 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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