- 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.
Caution is necessary for at least four weeks.
- Day 2: start administration of doxepin in a low dosage of 25 mg/day.
- Day 15: increase dosage of doxepin to 50 mg/day.
- Day 29: increase dosage of doxepin to 75 mg/day.
- Fluoxetine and norfluoxetine slow the metabolism of doxepin 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 doxepin.
- KNMP; Informatorium Medicamentorum 2023; Monografie "doxepine" (Dutch)
- 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.
The editors of psychiatrienet.nl take the greatest care to provide up-to-date and accurate information on this site. Nevertheless, mistakes and omissions cannot be entirely excluded. No rights devolve from the information provided. The editors and other providers of information to this site accept no responsibility for the content of this site or for the information provided therein; neither do they accept responsibility for possible damages which may derive from the use of the information on this site or from the linked sites. The editorial board accepts no responsibility for the content of the (linked) sites, for access to them, or for the products and services on these sites, nor for the occurrence of errors, viruses, and/or disruptions in service.