Difference between revisions of "Fluoxetine-duloxetine"
From Psychiatrienet
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| to = duloxetine | | to = duloxetine | ||
| stop = | | stop = | ||
| − | + | {{stopFluoxetine1}} | |
| − | |||
| start = | | start = | ||
No wash-out period is needed. | No wash-out period is needed. | ||
| − | * '''Day | + | * '''Day 2:''' start duloxetine the next day in low dosage of 30 mg/day. |
| − | * '''Day | + | * '''Day 29:''' increase dosage of duloxetine to normal, 60 mg/day. |
| info = | | info = | ||
| + | {{longt1/2fluvox}} | ||
* Desmethylfluoxetine has a halflife of at least 1 week: it takes therefore 1 month for elemination. | * Desmethylfluoxetine has a halflife of at least 1 week: it takes therefore 1 month for elemination. | ||
* Through CYP2D6 fluoxetine and duloxetine can mutually influence their metabolism. | * Through CYP2D6 fluoxetine and duloxetine can mutually influence their metabolism. | ||
* {{theorSS}} | * {{theorSS}} | ||
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}} | }} | ||
Revision as of 14:37, 28 October 2015
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Switch medication from fluoxetine to duloxetine.[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 duloxetineNo wash-out period is needed.
- Day 2: start duloxetine the next day in low dosage of 30 mg/day.
- Day 29: increase dosage of duloxetine to normal, 60 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.
- Desmethylfluoxetine has a halflife of at least 1 week: it takes therefore 1 month for elemination.
- Through CYP2D6 fluoxetine and duloxetine can mutually influence their metabolism.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- ↑ 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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