Switch medication from paroxetine to trazodone.
- Before day 1: gradually reduce dosage of paroxetine to a maximum of 20 mg/day when this dosage is > 20 mg/day.
- Day 1: reduce dosage of paroxetine to a maximum of 10 mg/day.
- Day 8: stop administration of paroxetine.
- Day 9: start trazodone in dosage of 100-150 mg/day.
- Day 16: If necessary, increase the dosage of trazodone every 3-4 days with 50 mg to a maximum of 400 mg/day.
- Paroxetine slows the metabolism of trazodone via CYP2D6, so caution is necessary.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
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