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Switch medication from clomipramine to tranylcypromine.[1] [2]
Stop clomipramine - Before day 1: gradually reduce dosage of clomipramine to a maximum of 75 mg/ day, when this dosage is > 75 mg/day.
- Day 1-3: reduce dosage of clomipramine to 50 mg/day.
- Day 4-7: reduce dosage of clomipramine to 25 mg/day.
- Day 8: stop administration of clomipramine.
Start tranylcypromine- Day 8-21: a wash-out period of two weeks is necessary.
- Day 22-30: start administration of tranylcypromine in a low dosage of 20 mg/day for one week.
- Day 31: after this week the dosage of tranylcypromine can be increased if necessary.
Cave- Occurrence of the serotonin syndrome is possible without wash-out period.
- ↑ 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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