* '''Before day 1:''' gradually reduce dosage of escitalopram fluoxetine to a maximum of 10 20 mg/day, when this dosage is > 10 20 mg/day. * '''Day 1:''' when a dosage of 10 mg/day is reached, stop administration

* '''Day 1-21:''' A wash-out period is not necessary, but care is needed.* '''Day 122:''' start administration of Start vortioxetine in a dosage of 10 mg/day.* '''After day 28 :''' If necessary, increase gradually the dosage of vortioxetine.| info =* Fluoxetine is a strong inhibitor slows the metabolism of vortioxetine via CYP2D6, which metabolizes vortioxetine. * Occurrence of serotonin syndrome is theoretically possible, so caution is necessaryfor at least four weeks after stopping fluoxetine.* Patients could be directly switched from a SSRI or a SNRI to vortioxetine 10 mg/day. One week after initiation with vortioxetine, the dosage could be increased from 10 mg/day to 20 mg/day.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/25087600 Montgomery SA et al. A randomised, double-blind study in adults with major depressive disorder with an inadequate response to a single course of selective serotonin reuptake inhibitor or serotonin-noradrenaline reuptake inhibitor treatment switched to vortioxetine or agomelatine. Hum Psychopharmacol. 2014 Sep;29(5):470-82.]</ref> {{theorSS}