Trazodone-vortioxetine

Before day 1: gradually reduce dosage of trazodone to a maximum of 150 mg/day, when this dosage is > 150 mg/day.
Day 1: reduce the dosage of trazodone to 75-100 mg/day.
Day 8: when a dosage of 75 mg/day is reached, stop administration

Start vortioxetine

A wash-out period is not necessary.
Day 8: start administration of vortioxetine in a normal dosage of 10 mg/day.

More information

Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
The content of trazodone in the tablet, for example 100 mg or 150 mg, determines which exact doses are given.
Patients could be directly switched from a SSRI or a SNRI to vortioxetine 10 mg/day. One week after initiation with vortioxetine, the dosage could be increased from 10 mg/day to 20 mg/day.^[3]

↑ 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.
↑ Montgomery SA et al. A randomised, double-blind study in adults with major depressive disorder with an inadequate response to a single course of selective serotonin reuptake inhibitor or serotonin-noradrenaline reuptake inhibitor treatment switched to vortioxetine or agomelatine. Hum Psychopharmacol. 2014 Sep;29(5):470-82.

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[1] 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

[2] Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.

[3] Montgomery SA et al. A randomised, double-blind study in adults with major depressive disorder with an inadequate response to a single course of selective serotonin reuptake inhibitor or serotonin-noradrenaline reuptake inhibitor treatment switched to vortioxetine or agomelatine. Hum Psychopharmacol. 2014 Sep;29(5):470-82.

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Trazodone-vortioxetine

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