Difference between revisions of "Fluoxetine-paroxetine"
From Psychiatrienet
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| to = paroxetine | | to = paroxetine | ||
| stop = | | stop = | ||
| − | + | {{stopFluoxetine1}} | |
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| start = | | start = | ||
| − | No wash-out period is needed. | + | * No wash-out period is needed. |
| − | * '''Day | + | * '''Day 2:''' start paroxetine the next day in low dosage of 10 mg/day. |
| − | * '''Day | + | * '''Day 15:''' increase dosage of paroxetine to 20 mg/day. |
| info = | | info = | ||
| − | + | {{longt1/2fluvox}} | |
* {{theorSS}} | * {{theorSS}} | ||
| − | * Fluoxetine and norfluoxetine inhibit de metabolism of paroxetine via CYP2D6 | + | * Fluoxetine and norfluoxetine inhibit de metabolism of paroxetine via CYP2D6. |
| − | * Paroxetine | + | * Paroxetine inhibits the metabolism of fluoxetine via CYP2D6. |
}} | }} | ||
Latest revision as of 11:45, 28 October 2015
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Switch medication from fluoxetine to paroxetine.[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 paroxetine- No wash-out period is needed.
- Day 2: start paroxetine the next day in low dosage of 10 mg/day.
- Day 15: increase dosage of paroxetine to 20 mg/day.
More information- Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Fluoxetine and norfluoxetine inhibit de metabolism of paroxetine via CYP2D6.
- Paroxetine inhibits the metabolism of fluoxetine via CYP2D6.
- ↑ 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
- ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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