Fluoxetine-duloxetine

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Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine
Duloxetine
Type Antidepressant
Group SNRI
links
Medscape Duloxetine
PubChem 60835
PubMed Duloxetine
Kompas (Dutch) Duloxetine
Wikipedia Duloxetine

Switch medication from fluoxetine to duloxetine.[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 duloxetine

No wash-out period is needed.

  • Day 2: start duloxetine the next day in low dosage of 30 mg/day.
  • Day 29: increase dosage of duloxetine to normal, 60 mg/day.
Infobord.png More information
  • Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
  • Desmethylfluoxetine has a halflife of at least 1 week: it takes therefore 1 month for elemination.
  • Through CYP2D6 fluoxetine and duloxetine can mutually influence their metabolism.
  • Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
  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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