Difference between revisions of "Paroxetine-amitriptyline"
From Psychiatrienet
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| from = paroxetine | | from = paroxetine | ||
| to = amitriptyline | | to = amitriptyline | ||
| − | | stop = | + | | stop = {{StopSSRI,SNRI}} |
| − | {{ | ||
| start = | | start = | ||
| − | * '''Day | + | * '''Day 1:''' start administration of amitriptyline in a low dosage of 25mg/day. |
| − | * '''Day | + | * '''Day 8:''' increase dosage of amitriptyline to a dosage of 50 mg/day. |
| info = | | info = | ||
| − | * Paroxetine slows the metabolism of amitriptyline via CYP2D6. | + | * Paroxetine slows the metabolism of amitriptyline via CYP2D6 inhibition. |
| + | * {{SSCYPinh}} | ||
| + | * {{TCAplasmalevelmonitoring}} | ||
}} | }} | ||
Latest revision as of 14:27, 30 June 2023
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Switch medication from paroxetine to amitriptyline.[1] [2]
Stop paroxetine - Day 1: Decrease dose to 50%
- Day 8: Stop
Start amitriptyline- Day 1: start administration of amitriptyline in a low dosage of 25mg/day.
- Day 8: increase dosage of amitriptyline to a dosage of 50 mg/day.
More information- Paroxetine slows the metabolism of amitriptyline via CYP2D6 inhibition.
- Due to CYP inhibition a longer period of time is needed to reach steady state concentration. Please keep in mind when monitoring plasma levels
- Plasma monitoring for TCA's is advisable, because of plasma-reponse relations, genetic polymorphism and under or overdosing.[3]
- ↑ 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.
- ↑ (dutch) monografie.org tricyclische-antidepressiva
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