Fluoxetine-doxepine

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Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine
Doxepin
Type antidepressant
Group TCA
links
ATC-code N06AA12
Medscape Doxepin
PubChem 3158
PubMed Doxepin
Drugs.com doxepin
Kompas (Dutch) Doxepin
Wikipedia Doxepin

Switch medication from fluoxetine to doxepin.[2] [3]

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 doxepin

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.
Infobord.png More information
  • 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.
  1. 1.0 1.1 1.2 1.3 1.4 KNMP; Informatorium Medicamentorum 2023; Monografie "doxepine" (Dutch)
  2. 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
  3. Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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