Fluoxetine-duloxetine
From Psychiatrienet
| ||||||||||||||||||||||
| ||||||||||||||||||||||
Switch medication from fluoxetine to duloxetine.[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 duloxetineNo wash-out period is needed.
- Day 2: start duloxetine the next day in low dosage of 30 mg/day.
- Day 29: increase dosage of duloxetine to normal, 60 mg/day.
More information- Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
- Desmethylfluoxetine has a halflife of at least 1 week: it takes therefore 1 month for elemination.
- Through CYP2D6 fluoxetine and duloxetine can mutually influence their metabolism.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- ↑ 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.
The editors of psychiatrienet.nl take the greatest care to provide up-to-date and accurate information on this site. Nevertheless, mistakes and omissions cannot be entirely excluded. No rights devolve from the information provided. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. The editorial board accepts no responsibility for the content of the (linked) sites, for access to them, or for the products and services on these sites, nor for the occurrence of errors, viruses, and/or disruptions in service.
