Switch medication from doxepin to paroxetine.[2]
[3]
Stop doxepin
- Before day 1: gradually reduce dosage of doxepin to a maximum of 100 mg/day.
- Day 1: reduce dosage of doxepin to 50 mg/day.
- Day 8: reduce dosage of doxepin to 25 mg/day.
- Day 15: stop administration of doxepin.
Start paroxetine
- Day 15: start administration of paroxetine in a normal dosage of 20 mg/day.
More information
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Paroxetine is a strong inhibitor of CYP2D6, which metabolizes doxepin.
- This switch is currently being reviewed.
- ↑ 1.0 1.1 1.2 1.3 1.4 KNMP; Informatorium Medicamentorum 2023; Monografie "doxepine" (Dutch)
- ↑ 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 doxepin 
Start paroxetine
More information