Paroxetine-nortriptyline
From Psychiatrienet
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Switch medication from paroxetine to nortriptyline.[1] [2]
Stop paroxetine - Day 1: Decrease with about 25% of original dose every 3-4 days
Start nortriptylineCaution is necessary.
- Day 1: start administration of nortriptyline in a low dosage of 25 mg/day.
- Day Stop paroxetine: increase administration of nortriptyline to a dosage of 50 mg/day.
More information- Paroxetine slows the metabolism of nortriptyline via CYP2D6.
- Due to CYP inhibition a longer period of time is needed to reach steady state concentration. Please keep in mind when monitoring plasma levels
- Plasma monitoring for TCA's is advisable, because of plasma-reponse relations, genetic polymorphism and under or overdosing.[3]
- ↑ 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.
- ↑ (dutch) monografie.org tricyclische-antidepressiva
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