Switch medication from paroxetine to dosulepine.[1]
[2]
Stop paroxetine
- Day 1: Decrease dose to 50%
- Day 8: Stop
Start dosulepine
- Day 1: start administration of dosulepine in a low dosage of 25 mg/day.
- Day 8: increase dosage of dosulepine to a dosage of 75 mg/day.
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- Paroxetine slows the metabolism of dosulepine via CYP2D6 inhibition.
-
- Due to CYP inhibition a longer period of time is needed to reach steady state concentration. Please keep in mind when monitoring plasma levels
-
- Plasma monitoring for TCA's is advisable, because of plasma-reponse relations, genetic polymorphism and under or overdosing.[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.
- ↑ (dutch) monografie.org tricyclische-antidepressiva
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Stop paroxetine 
Start dosulepine
More information