Fluoxetine-trazodone
From Psychiatrienet
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Switch medication from fluoxetine to trazodone.[1] [2]
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.
Start trazodone- Day 2-22: A wash-out period is needed.
- Day 23: Start trazodone in a dosage of 100-150 mg/day.
- After day 29: If necessary, increase gradually the dosage of trazodone to a maximum of 400 mg/day.
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.
- Fluoxetine slows the metabolism of trazodone via CYP2D6, so caution is necessary for at least four weeks.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- ↑ 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.
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