Paroxetine-nortriptyline
From Psychiatrienet
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Switch medication from paroxetine to nortriptyline.[1] [2]
Stop paroxetine - Day 0: gradually reduce dosage of paroxetine to a maximum of 20 mg/day when this dosage is > 20 mg/day.
- Day 1: Reduce dosage of paroxetine to a maximum of 10 mg/day.
- Day 8: reduce dosage of paroxetine to 5 mg/day.
Start nortriptyline- Day 8: simultaneously start administration of nortriptyline in a low dosage of 25 mg/day.
- Day 15: stop administration of paroxetine and only continue nortriptyline in a dosage of 50 mg/day.
- “Start low, go slow” is not required, but caution is necessary.
More informationParoxetine slows the metabolism of nortriptyline via CYP2D6.
- ↑ 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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