Switch medication from nortriptyline to paroxetine.[1]
[2]
Stop nortriptyline
- Day 1: reduce dosage to 50%.
- Day 8: stop
Start paroxetine
- Day 1: Start with 50% of the target dose
- Day 8: Increase dose to 100% of the target dose
- Day 9 and after: Gradually increase dose as necessary
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- Paroxetine is a strong inhibitor of CYP2D6, which metabolizes nortriptyline.
- Safe target dose paroxetine = 20 mg
- ↑ 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 nortriptyline 
Start paroxetine
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