Switch medication from imipramine to escitalopram.[1]
[2]
Stop imipramine
- Before day 1: gradually reduce dosage of imipramine to a maximum of 75 mg/day.
- Day 1: reduce dosage of imipramine to 50 mg/day.
- Day 3: reduce dosage of imipramine to 25 mg/day.
- Day 8: stop administration of imipramine.
Start escitalopram
- Day 1: simultaneously start administration of escitalopram in a normal dosage of 10 mg/day.
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- Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
- Citalopram/escitalopram are a weak inhibitor of CYP2D6, which metabolizes imipramine.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- ↑ 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 imipramine 
Start escitalopram
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