Switch medication from maprotiline to fluoxetine.[1]
[2]
Stop maprotiline
- Before day 0: gradually reduce dosage of maprotiline to a maximum of 75 mg/day.
- Day 1: reduce dosage of maprotiline to 50 mg/day.
- Day 3: reduce dosage of maprotiline to 25 mg/day.
Start fluoxetine
- Day 1: simultaneously start administration of fluoxetine in a normal dosage of 20 mg/day.
- Day 8: stop administration of maprotiline and continue administration of fluoxetine.
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- Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
- Fluoxetine is a strong inhibitor of CYP2D6, which metabolizes maprotiline.
- ↑ 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 maprotiline 
Start fluoxetine
More information