Fluvoxamine-agomelatine

Before day 1: gradually reduce dosage of fluvoxamine to a maximum of 50 mg/day, when this dosage is > 50 mg/day.
Day 1: reduce dosage of fluvoxamine further to 25 mg/day.
Day 8: stop administration of fluvoxamine.

Start agomelatine

Day 1: simultaneously start administration of agomelatine in a dosage of 25 mg/day.^[4]
If necessary, increase dosage of agomelatine to 50 mg/day.

More information

Fluvoxamine inhibits the metabolism of agomelatine via CYP1A2 (90%) and via CYP2C9/2C19 (10%).^[4]
The reduction of the SSRI doses in 7-14 days could cause emotional instability, headache and flu-like symptoms. One could extend this period.

↑ 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.
↑ CBG meb, accessed august 2023,SmPC Valdoxan
↑ ^4.0 ^4.1 McAllister-Williams RH et al. The use of antidepressants in clinical practice: focus on agomelatine. Hum Psychopharmacol. 2010 Mar 1;25(2):95-102

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[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.

[3] CBG meb, accessed august 2023,SmPC Valdoxan

[agoswitch-4] 4.0 ^4.1 McAllister-Williams RH et al. The use of antidepressants in clinical practice: focus on agomelatine. Hum Psychopharmacol. 2010 Mar 1;25(2):95-102

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Fluvoxamine-agomelatine

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