Difference between revisions of "Fluoxetine-clomipramine"
From Psychiatrienet
| Line 3: | Line 3: | ||
| to = clomipramine | | to = clomipramine | ||
| stop = | | stop = | ||
| − | + | {{stopFluoxetine1}}. | |
| − | |||
| start = | | start = | ||
Caution is necessary for at least four weeks. | Caution is necessary for at least four weeks. | ||
| − | * '''Day | + | * '''Day 2:''' start administration of clomipramine in a low dosage of 25 mg/day. |
| − | * '''Day | + | * '''Day 9:''' increase dosage of clomipramine to 50 mg/day. |
| − | * '''Day | + | * '''Day 29:''' gradually increase dosage of clomipramine to 75 mg/day and more. |
| info = | | info = | ||
* Fluoxetine and norfluoxetine slow the metabolism of clomipramine via CYP2D6. | * Fluoxetine and norfluoxetine slow the metabolism of clomipramine via CYP2D6. | ||
| − | + | {{longt1/2fluvox}} | |
* Start low, go slow for clomipramine. | * Start low, go slow for clomipramine. | ||
| − | |||
}} | }} | ||
Revision as of 14:35, 28 October 2015
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Switch medication from fluoxetine to clomipramine.[1] [2]
Stop fluoxetine - Before day 1: reduce dosage of fluoxetine with about 20 mg per week.
- Day 1: when a dosage of 20 mg/day is reached, stop fluoxetine..
Start clomipramineCaution is necessary for at least four weeks.
- Day 2: start administration of clomipramine in a low dosage of 25 mg/day.
- Day 9: increase dosage of clomipramine to 50 mg/day.
- Day 29: gradually increase dosage of clomipramine to 75 mg/day and more.
More information- Fluoxetine and norfluoxetine slow the metabolism of clomipramine via CYP2D6.
- Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
- Start low, go slow for clomipramine.
- ↑ 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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