Switch medication from clomipramine to tranylcypromine.
- Decrease with about 25% of the original dose per 3 days.
- Stop and wait 14 days for washout
- a wash-out period of two weeks is necessary.
- Start tranylcypromine in a low dosage of 20 mg/day for one week.
- After this week the dosage of tranylcypromine can be increased.
- Occurrence of the serotonin syndrome is possible without wash-out period.
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