Paroxetine-clomipramine
From Psychiatrienet
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Switch medication from paroxetine to clomipramine.[1] [2]
- Before day 1: 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: stop dosage of paroxetine.
Caution is necessary.
- Day 8: start administration of clomipramine in a low dosage of 25-50 mg/day.
- Day 15: increase dosage of clomipramine to 50-100 mg/day.
- Day 28: if necessary, increase dosage of clomipramine.
- Paroxetine slows the metabolism of clomipramine via CYP2D6.
- This switch is currently being reviewed.
- ↑ 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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