Switch medication from citalopram to fluoxetine.[1]
[2]
Stop citalopram
- Before day 1: gradually reduce dosage of citalopram to a maximum of 20 mg/day, when this dosage is > 20 mg/day.
- Day 1: reduce dosage of citalopram to a maximum of 10 mg/day.
- Day 8: stop administration of citalopram
Start fluoxetine
- No wash-out period is needed.
- Start fluoxetine the next day in normal dosage of 20 mg/day.
More information
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Fluoxetine slows the metabolism of citalopram by inhibition of CYP2C19, CYP2D6 and CYP3A4
- This switch is currently being reviewed.
- ↑ 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 citalopram 
Start fluoxetine
More information