Switch medication from fluoxetine to tranylcypromine.
- Before day 1: reduce dosage of fluoxetine with about 20 mg per week.
- Day 1: when a dosage of 20 mg/day is reached, stop fluoxetine.
- Day 1-35: a wash-out period of five weeks is necessary because of the long half live.
- Day 36: start tranylcypromine in a low dosage of 20 mg/day for one week.
- Day 43: after this week gradually increase the dosage of tranylcypromine.
- Occurrence of the serotonin syndrome is possible without wash-out period.
- Desmethylfluoxetine has a half live of about one week so a long wash-out period is necessary.
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