Difference between revisions of "Paroxetine-maprotiline"

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| from = paroxetine  
 
| from = paroxetine  
 
| to = maprotiline
 
| to = maprotiline
| stop =  
+
| stop =
* '''Before day 1:''' gradually reduce dosage of paroxetine to a maximum of 20 mg/day when this dosage is > 20 mg/day.
+
* '''Day 1:''' Decrease with about 25% of original dose every 3-4 days
* '''Day 1:''' reduce dosage of paroxetine to a maximum of 10 mg/day.
 
* '''Day 8:''' stop dosage of paroxetine.
 
 
| start =  
 
| start =  
 
Caution is necessary.
 
Caution is necessary.
* '''Day 8:''' start administration of maprotiline in a low dosage of 25 mg/day.  
+
* '''Day 1:''' start administration of maprotiline in a low dosage of 25 mg/day.  
* '''Day 15:''' increase administration of maprotiline to a dosage of 50-100 mg/day.
+
* '''Day Stop paroxetine:''' increase administration of maprotiline to a dosage of 50 mg/day.
* "Start low, go slow" is not required, but caution is necessary!
+
 
 
| info =  
 
| info =  
* Paroxetine slows the metabolism of maprotiline via CYP1A2 and CYP2D6.  
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* Paroxetine slows the metabolism of maprotiline via CYP2D6.  
{{review}}
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* {{SSCYPinh}}
 +
* {{TCAplasmalevelmonitoring}}
 
}}
 
}}

Latest revision as of 15:31, 30 June 2023

paroxetine
Type Antidepressant
Group SSRI
links
Medscape paroxetine
PubChem 43815
PubMed paroxetine
Kompas (Dutch) paroxetine
Wikipedia paroxetine
Maprotiline
Type Antidepressant
Group NRI
links
Medscape Maprotiline
PubChem 4011
PubMed Maprotiline
Kompas (Dutch) Maprotiline
Wikipedia Maprotiline

Switch medication from paroxetine to maprotiline.[1] [2]

Nietinrijdenbord.png Stop paroxetine
  • Day 1: Decrease with about 25% of original dose every 3-4 days
Eenrichtingbord.png Start maprotiline

Caution is necessary.

  • Day 1: start administration of maprotiline in a low dosage of 25 mg/day.
  • Day Stop paroxetine: increase administration of maprotiline to a dosage of 50 mg/day.
Infobord.png More information
  • Paroxetine slows the metabolism of maprotiline via CYP2D6.
  • 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]
  1. 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
  2. Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
  3. (dutch) monografie.org tricyclische-antidepressiva
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