Difference between revisions of "Fluoxetine-escitalopram"
From Psychiatrienet
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− | + | {{Drugswitch | |
+ | | from = fluoxetine | ||
+ | | to = escitalopram | ||
+ | | stop = | ||
+ | * Gradually reduce dosage of fluoxetine to a maximum of 20 mg/ day, when this dosage is > 20 mg/day. | ||
+ | * When a dosage of 20 mg/day is reached, stop administration. | ||
+ | | start = | ||
+ | * No wash-out period is needed. | ||
+ | * '''Day 1:''' start escitalopram the next day in low dosage of 5 mg/day. | ||
+ | * '''Day 14:''' increase dosage of escitalopram to normal, i.e. 10 mg/day. | ||
+ | | info = | ||
+ | * Fluoxetine has a very long elimination time; phasing out fluoxetine is therefore not necessary. | ||
+ | * {{theorSS}} | ||
+ | * Fluoxetine inhibits CYP2C19, CYP2D6 and CYP3A4, which metabolize escitalopram. | ||
+ | }} |
Revision as of 23:27, 4 March 2010
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Switch medication from fluoxetine to escitalopram.[1] [2]
- Gradually reduce dosage of fluoxetine to a maximum of 20 mg/ day, when this dosage is > 20 mg/day.
- When a dosage of 20 mg/day is reached, stop administration.
- No wash-out period is needed.
- Day 1: start escitalopram the next day in low dosage of 5 mg/day.
- Day 14: increase dosage of escitalopram to normal, i.e. 10 mg/day.
- Fluoxetine has a very long elimination time; phasing out fluoxetine is therefore not necessary.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Fluoxetine inhibits CYP2C19, CYP2D6 and CYP3A4, which metabolize escitalopram.
- ↑ 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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