| stop = {{downparoxStopSSRI,SNRI}}

* A wash-out period is not necessary'''Day 1:''' start administration of vortioxetine in a low dosage of 5 mg/day.* '''Day 158:''' start administration increase dosage of vortioxetine in to a normal dosage of 10 mg/day.

* Paroxetine is a strong inhibitor slows the metabolism of CYP2D6, which metabolizes vortioxetine. * Occurrence via inhibition of serotonin syndrome is theoretically possible, so caution is necessary.* Patients could be directly switched from a SSRI or a SNRI to vortioxetine 10 mg/day. One week after initiation with vortioxetine, the dosage could be increased from 10 mg/day to 20 mg/day.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/25087600 Montgomery SA et al. A randomised, double-blind study in adults with major depressive disorder with an inadequate response to a single course of selective serotonin reuptake inhibitor or serotonin-noradrenaline reuptake inhibitor treatment switched to vortioxetine or agomelatine. Hum Psychopharmacol. 2014 Sep;29(5):470-82CYP2D6.]</ref>