Fluoxetine-maprotiline
From Psychiatrienet
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Switch medication from fluoxetine to maprotiline.[1] [2]
Stop fluoxetine {[stopFluoxetine
- ↑ 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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| start = Caution is necessary for at least four weeks.
- Day 2: start administration of maprotiline in a low dosage of 25 mg/day.
- Day 15: increase dosage of maprotiline to 50 mg/day.
- Day 29: gradually increase dosage of maprotiline to 75 mg/day and more.
| info =
- Fluoxetine and norfluoxetine slow the metabolism of maprotiline via CYP2D6.
- Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
- Start low, go slow for maprotiline.
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