Switch medication from amitriptyline to fluvoxamine.[1]
[2]
Stop amitriptyline
- Before day 1: gradually reduce dosage of amitriptyline to a maximum of 50 mg/day.
- Day 1: reduce dosage of amitriptyline to 25 mg/day.
- Day 8: stop dosage of amitriptyline.
Start fluvoxamine
- Day 8: start administration of fluvoxamine in a normal dosage of 50 mg/day.
- Day 15: increase dosage of fluvoxamine.
More information
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Fluvoxamine is an inhibitor of CYP1A2, CYP2C19 and CYP3A4 (moderate), which metabolize amitriptyline.
- ↑ 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 amitriptyline 
Start fluvoxamine
More information