Switch medication from clomipramine to citalopram.[1]
[2]
Stop clomipramine
- Before day 1: gradually reduce dosage of clomipramine to a maximum of 50 mg/day.
- Day 1: reduce dosage of clomipramine to 25 mg/day.
- Day 3: reduce dosage of clomipramine to 10 mg/day.
Start citalopram
- Day 1: simultaneously start administration of citalopram/escitalopram in a normal dosage of 20 mg/day, resp. 10 mg/day.
- Day 8: stop administration of clomipramine and continue administration of citalopram/escitalopram.
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- Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
- Citalopram/escitalopram are very weak inhibitors of CYP2D6, which metabolizes clomipramine.
- ↑ 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 clomipramine 
Start citalopram
More information