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Fluoxetine-clomipramine

Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine
Clomipramine
Type Antidepressant
Group TCA
links
ATC-code N06AA04
Medscape Clomipramine
PubChem 2801
PubMed Clomipramine
Kompas (Dutch) Clomipramine
Wikipedia Clomipramine

Switch medication from fluoxetine to clomipramine.[1] [2]

Nietinrijdenbord.png Stop fluoxetine
  • Before day 1: reduce dosage of fluoxetine with about 20 mg per week.
  • Day 1: when a dosage of 20 mg/day is reached, stop fluoxetine.
Eenrichtingbord.png Start clomipramine

Caution is necessary for at least four weeks.

  • Day 2: start administration of clomipramine in a low dosage of 25 mg/day.
  • Day 9: increase dosage of clomipramine to 50 mg/day.
  • Day 29: gradually increase dosage of clomipramine to 75 mg/day and more.
Infobord.png More information
  • Fluoxetine and norfluoxetine slow the metabolism of clomipramine 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 clomipramine.
  1. 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
  2. Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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