Switch medication from mirtazapine to fluvoxamine.
- Before day 1: Gradually reduce dosage of mirtazapine to a maximum of 30 mg/day, when this dosage is > 30 mg/day.
- Day 1: Reduce dosage of mirtazapine to 15 mg/day.
- Day 8: Stop administration of mirtazapine.
- Day 2: Start administration of fluoxetine in a dosage of 20 mg/day.
- After 3 weeks: If necessary, gradually increase dosage of fluoxetine to max. 60 mg/day
- Fluvoxamine slows the metabolism of mirtazapine via CYP1A2, CYP2C9, CYP2D6 and CYP3A4.
- Pharmacokinetic interaction is not important because of low plasma levels.
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