Difference between revisions of "Paroxetine-vortioxetine"
From Psychiatrienet
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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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Revision as of 16:47, 4 March 2015
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Switch medication from paroxetine to vortioxetine.[1] [2]
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.
Start vortioxetine- A wash-out period is not necessary.
- Day 15: start administration of vortioxetine in a normal dosage of 10 mg/day.
More information- Paroxetine is a strong inhibitor of CYP2D6, which metabolizes vortioxetine.
- 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.[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.
- ↑ 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.
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