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 16: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.
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.
Stop amitriptyline 
Start fluoxetine
More information