Switch medication from mianserine to duloxetine.[1]
[2]
Stop mianserine
- Before day 1: gradually reduce dosage of mianserine to a maximum of 60 mg/ day.
- Day 1: reduce a dosage of 60 mg/day to 30 mg/day.
Start duloxetine
- Day 1: simultaneously start duloxetine in a low dosage of 30 mg/day.
- Day 8: stop administration of mianserine and only continue administration of duloxetine in a dosage of 60 mg/day.
- If necessary, increase the dosage of duloxetine.
More information
- Caution with this switch is necessary, because duloxetine slows the metabolism of mianserine via CYP2D6.
- ↑ 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 mianserine 
Start duloxetine
More information