Switch medication from nortriptyline to paroxetine.
- Before day 1: gradually reduce dosage of nortriptyline to a maximum of 100 mg/day.
- Day 1: reduce dosage of nortriptyline to 50 mg/day.
- Day 3: reduce dosage of nortriptyline to 25 mg/day.
- Day 8: stop administration of nortriptyline.
- Day 1: simultaneously start administration of paroxetine in a low dosage of 10 mg/day.
- Day 8: stop administration of nortriptyline and continue administration of paroxetine in a dosage of 20 mg/day.
- Paroxetine is a strong inhibitor of CYP2D6, which metabolizes nortriptyline.
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