Switch medication from duloxetine to paroxetine.
- Before day 1: gradually reduce dosage of duloxetine to a maximum of 60 mg/ day, when this dosage is > 60 mg/day.
- Day 1: reduce dosage of duloxetine to a maximum of 30 mg/day.
- Day 8: stop administration of duloxetine.
- Day 9: start paroxetine in a normal dosage of 20 mg/day.
- Paroxetine and duloxetine slow each others metabolism by CYP2D6-inhibition.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
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