Fluoxetine-paroxetine

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Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine
paroxetine
Type Antidepressant
Group SSRI
links
Medscape paroxetine
PubChem 43815
PubMed paroxetine
Kompas (Dutch) paroxetine
Wikipedia paroxetine

Switch medication from fluoxetine to paroxetine.[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 paroxetine
  • No wash-out period is needed.
  • Day 2: start paroxetine the next day in low dosage of 10 mg/day.
  • Day 15: increase dosage of paroxetine to 20 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.
  • Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
  • Fluoxetine and norfluoxetine inhibit de metabolism of paroxetine via CYP2D6.
  • Paroxetine inhibits the metabolism of fluoxetine via CYP2D6.
  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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