Difference between revisions of "Nortriptyline-fluoxetine"
From Psychiatrienet
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* '''Day 1:''' simultaneously start administration of fluoxetine in a normal dosage of 20 mg/day. | * '''Day 1:''' simultaneously start administration of fluoxetine in a normal dosage of 20 mg/day. | ||
* '''Day 8:''' stop administration of nortriptyline and continue administration of fluoxetine. | * '''Day 8:''' stop administration of nortriptyline and continue administration of fluoxetine. | ||
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* Fluoxetine is a strong inhibitor of CYP2D6, which metabolizes nortriptyline. }} | * Fluoxetine is a strong inhibitor of CYP2D6, which metabolizes nortriptyline. }} | ||
Revision as of 14:07, 2 November 2015
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Switch medication from nortriptyline to fluoxetine.[1] [2]
Stop nortriptyline - Before day 1: gradually reduce dosage of nortriptyline to a maximum of 50 mg/ day, when this dosage is > 50 mg/day.
- Day 1-3: reduce dosage of nortriptyline to 25 mg/day.
- Day 4-7: reduce dosage of nortriptyline to 10 mg/day.
- Day 8: stop administration of nortriptyline.
Start fluoxetine- Day 1: simultaneously start administration of fluoxetine in a normal dosage of 20 mg/day.
- Day 8: stop administration of nortriptyline and continue administration of fluoxetine.
More information- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Fluoxetine is a strong inhibitor of CYP2D6, which metabolizes nortriptyline.
- ↑ 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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