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Switch medication from citalopram to tranylcypromine.[1] [2]
Stop citalopram - Day 1: reduce dosage of citalopram to a maximum of 20 mg/day
- Day 8: reduce dosage of citalopram to 10 mg/day
- Day 15: stop citalopram
Start tranylcypromine- Day 15-29: a wash-out period of two weeks is safe even in liver malfunction and in the elderly.
- Day 30: Start administration of tranylcypromine in low dosage of 20 mg/day for one week.
- Day 37: after this week the dosage of tranylcypromine can be increased if necessary.
Cave- Occurrence of serotonin syndrome is reported when a wash-out period (of one week) is not considered.
- The reduction of the SSRI doses in 7-14 days could cause emotional instability, headache and flu-like symptoms. One could extend this 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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