Switch medication from sertraline to amitriptyline.
- Before day 1: gradually reduce dosage of sertraline to a maximum of 50 mg/day when this dosage is > 50 mg/day.
- Day 1: reduce dosage of sertraline to a maximum of 25 mg/day.
- Day 8: stop administration of sertraline.
Caution is necessary.
- Day 1: simultaneously start administration of amitriptyline in a low dosage of 25 mg/day.
- Day 8: continue administration of amitriptyline in a dosage of 50 mg/day.
- Start low, go slow!
- Sertraline dose-dependently slows the metabolism of amitriptyline via CYP2D6.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- This switch is currently being reviewed.
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