Switch medication from citalopram to nortriptyline.[1]
[2]
Stop citalopram
- Day 0: 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.
Start nortriptyline
- Day 1: simultaneously start administration of nortriptyline in a normal dosage of 50 mg/day.
- Day 8: stop administration of citalopram/escitalopram and continue administration of nortriptyline only.
More information
- “Start low, go slow” for nortriptyline is not required, but caution is necessary.
- The same applies to escitalopram.
- ↑ 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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Stop citalopram 
Start nortriptyline
More information