Difference between revisions of "Fluoxetine-amitriptyline"
From Psychiatrienet
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| to = amitriptyline | | to = amitriptyline | ||
| stop = | | stop = | ||
| − | + | {{stopFluoxetine1}} | |
| − | |||
| start = | | start = | ||
Caution is necessary for at least four weeks. | Caution is necessary for at least four weeks. | ||
| − | * '''Day | + | * '''Day 5:''' start administration of amitriptyline in a low dosage of 25 mg/day. |
| − | + | * '''Day 15:''' increase dosage of amitriptyline to 50 mg/day. | |
| − | * '''Day 15:''' | + | * '''Day 20 and after:''' gradually increase dosage of amitriptyline if necessary. |
| info = | | info = | ||
| − | * Fluoxetine | + | * {{TCAplasmalevelmonitoring}} |
| − | * Start low, go slow for amitriptyline.}} | + | * Fluoxetine and norfluoxetine slow the metabolism of amitriptyline via CYP2D6. |
| + | * Start low, go slow for amitriptyline. | ||
| + | * {{theorSS}} | ||
| + | |||
| + | |||
| + | }} | ||
Latest revision as of 14:49, 20 February 2025
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Switch medication from fluoxetine to amitriptyline[1][2]
Stop fluoxetine - 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.
Start amitriptylineCaution is necessary for at least four weeks.
- Day 5: start administration of amitriptyline in a low dosage of 25 mg/day.
- Day 15: increase dosage of amitriptyline to 50 mg/day.
- Day 20 and after: gradually increase dosage of amitriptyline if necessary.
More information- Plasma monitoring for TCA's is advisable, because of plasma-reponse relations, genetic polymorphism and under or overdosing.[3]
- Fluoxetine and norfluoxetine slow the metabolism of amitriptyline via CYP2D6.
- Start low, go slow for amitriptyline.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Jump up ↑ 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
- Jump up ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
- Jump up ↑ (dutch) monografie.org tricyclische-antidepressiva
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