Difference between revisions of "Imipramine-fluoxetine"

From Psychiatrienet
Jump to: navigation, search
 
(3 intermediate revisions by 2 users not shown)
Line 1: Line 1:
 
{{Drugswitch  
 
{{Drugswitch  
 
| from = imipramine
 
| from = imipramine
| to = fluoxetine  
+
| to = fluoxetine
 
| stop =  
 
| stop =  
* '''Before day 1:''' gradually reduce dosage of imipramine to a maximum of 75 mg/day.
+
{{TCAdecrease25p3d}}
* '''Day 1:''' reduce dosage of imipramine to 50 mg/day.
 
* '''Day 3:''' reduce dosage of imipramine to 25 mg/day.
 
 
| start =  
 
| start =  
* '''Day 4:''' simultaneously start administration of fluoxetine in a normal dosage of 20 mg/day.
+
* '''Day 6 and after''': At approximately 50-25% of the original TCA dosering start fluoxetine at 100% of the target dose.
* '''Day 8:''' stop administration of imipramine and continue administration of fluoxetine.
+
* ''' After 3 weeks:''' If necessary, gradually increase dosage of fluoxetine.
 +
 
 
| info =  
 
| info =  
* Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
+
* Safe target dose fluoxetine = 20 mg
* Fluoxetine is a strong inhibitor of CYP2D6, which metabolizes imipramine.  
+
* Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong), which metabolize desipramine (a metabolite of imipramine).
{{review}} }}
+
}}

Latest revision as of 12:17, 8 March 2024

Imipramine
Type Antidepressant
Group TCA
links
Medscape Imipramine
PubChem 3696
PubMed Imipramine
Kompas (Dutch) Imipramine
Wikipedia Imipramine
Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine

Switch medication from imipramine to fluoxetine.[1] [2]

Nietinrijdenbord.png Stop imipramine
  • Day 1: Decrease with about 25% of the original dose per 3 days.
Eenrichtingbord.png Start fluoxetine
  • Day 6 and after: At approximately 50-25% of the original TCA dosering start fluoxetine at 100% of the target dose.
  • After 3 weeks: If necessary, gradually increase dosage of fluoxetine.
Infobord.png More information
  • Safe target dose fluoxetine = 20 mg
  • Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong), which metabolize desipramine (a metabolite of imipramine).
  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.
The editors of psychiatrienet.nl take the greatest care to provide up-to-date and accurate information on this site. Nevertheless, mistakes and omissions cannot be entirely excluded. No rights devolve from the information provided. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. The editorial board accepts no responsibility for the content of the (linked) sites, for access to them, or for the products and services on these sites, nor for the occurrence of errors, viruses, and/or disruptions in service.