Amitriptyline-fluoxetine
From Psychiatrienet
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Switch medication from amitriptyline to fluoxetine.[1] [2]
Stop amitriptyline - Day 1: Decrease with about 25% of the original dose per 3 days.
Start fluoxetine- Day 6 and after: At approximately 50-25% of the original TCA dosering start fluoxetine at 100% of the target dose.
More information- 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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