Switch medication from citalopram to doxepin.[2]
[3]
Stop citalopram
- Before day 1: gradually reduce dosage of citalopram/escitalopram to a maximum of 20 mg/ day resp. 10 mg/day, when this dosage is respectively > 20 mg/day and > 10 mg/day.
- Day 1: reduce dosage of citalopram/escitalopram to a maximum of 10 mg/ day resp. 5 mg/day.
- Day 8: stop administration of citalopram/escitalopram.
Start doxepin
- Day 8: start administration of doxepin in a normal dosage of 25 mg/day.
- Day 15: increase dosage of doxepin.
More information
- The same applies to escitalopram.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- ↑ 1.0 1.1 1.2 1.3 1.4 KNMP; Informatorium Medicamentorum 2023; Monografie "doxepine" (Dutch)
- ↑ 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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