Fluvoxamine-duloxetine

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• Before day 0: gradually reduce dosage of fluvoxamine to a maximum of 50 mg/day.
• Day 1: stop fluvoxamine.

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• Day 5: start duloxetine 30 mg/day.
• Day 14: increase administration of duloxetine to 60 mg/day.

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• Fluvoxamine inhibits the metabolism of duloxetine through CYP1A2.
• Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.