Difference between revisions of "Paroxetine-vortioxetine"

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* A wash-out period is not necessary.
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* '''Day 15-18:''' a wash-out period of 3 days is to prevent inhibition of the metabolism of vortioxetine.
* '''Day 15:''' start administration of vortioxetine in a normal dosage of 10 mg/day.
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* '''Day 18:''' start administration of vortioxetine in a normal dosage of 10 mg/day.
 
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* Paroxetine is a strong inhibitor of CYP2D6, which metabolizes vortioxetine.  
 
* Paroxetine is a strong inhibitor of CYP2D6, which metabolizes vortioxetine.  
 
* Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
 
* Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
* Patients could be directly switched from a SSRI or a SNRI to vortioxetine 10 mg/day. One week after initiation with vortioxetine, the dosage could be increased from 10 mg/day to 20 mg/day.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/25087600 Montgomery SA et al. A randomised, double-blind study in adults with major depressive disorder with an inadequate response to a single course of selective serotonin reuptake inhibitor or serotonin-noradrenaline reuptake inhibitor treatment switched to vortioxetine or agomelatine. Hum Psychopharmacol. 2014 Sep;29(5):470-82.]</ref>
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Latest revision as of 14:44, 12 March 2015

paroxetine
Type Antidepressant
Group SSRI
links
Medscape paroxetine
PubChem 43815
PubMed paroxetine
Kompas (Dutch) paroxetine
Wikipedia paroxetine
Vortioxetine
Type Antidepressant
Group SMS
links
Medscape Vortioxetine
PubChem 9966051
PubMed Vortioxetine
Kompas (Dutch) Vortioxetine
Wikipedia Vortioxetine

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

Nietinrijdenbord.png Stop paroxetine
  • Day -7: reduce dosage of paroxetine to 20 mg/day, if this dosage is > 20 mg/day.
  • Day 0: dosage of paroxetine is 20 mg/day.
  • Day 1: reduce dosage of paroxetine to 10 mg/day.
  • Day 8: reduce dosage of paroxetine to 5 mg/day.
  • Day 15: stop administration of paroxetine.
Eenrichtingbord.png Start vortioxetine
  • Day 15-18: a wash-out period of 3 days is to prevent inhibition of the metabolism of vortioxetine.
  • Day 18: start administration of vortioxetine in a normal dosage of 10 mg/day.
Infobord.png More information
  • Paroxetine is a strong inhibitor of CYP2D6, which metabolizes vortioxetine.
  • Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
  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.
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