Difference between revisions of "Amitriptyline-fluoxetine"
From Psychiatrienet
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| to = fluoxetine | | to = fluoxetine | ||
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− | {{ | + | {{stopAmitriptyline}} |
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− | * '''Day | + | * '''Day 9:''' start administration of fluoxetine in a normal dosage of 20 mg/day. |
− | * '''Day | + | * '''Day 16:''' if necessary, increase dosage of fluoxetine. |
| info = | | info = | ||
*{{theorSS}} | *{{theorSS}} | ||
* Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong) and CYP3A4 (moderate), which metabolize amitriptyline. | * Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong) and CYP3A4 (moderate), which metabolize amitriptyline. | ||
}} | }} |
Revision as of 12:53, 2 November 2015
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Switch medication from amitriptyline to fluoxetine.[1] [2]
- Before day 1: gradually reduce dosage of amitriptyline to a maximum of 50-100 mg/ day, when this dosage is > 100 mg/day.
- Day 1-3: reduce dosage of amitriptyline to 50 mg/day.
- Day 4-7: reduce dosage of amitriptyline to 25 mg/day.
- Day 8: stop administration of amitriptyline.
- Day 9: start administration of fluoxetine in a normal dosage of 20 mg/day.
- Day 16: if necessary, increase dosage of fluoxetine.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Fluoxetine and norfluoxetine are inhibitors of CYP2D6 (strong) and CYP3A4 (moderate), which metabolize amitriptyline.
- ↑ 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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