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Duloxetine-vortioxetine

682 bytes removed, 15:13, 12 March 2015
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* '''Before day 1:''' gradually reduce dosage of duloxetine to a maximum of 60 mg/day, when this dosage is > 60 mg/day.
* '''Day 1-7:''' reduce dosage of duloxetine from 60 mg/day to 30 mg/day.* '''Day 8-14:''' reduce dosage of duloxetine to 30 mg/day to 0 mg/day* '''Day 15:''' stop administration of duloxetine.  
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* A wash-out period of 3 days is not necessary, but care is neededadvisable.* '''Day 1511:''' Start administration of vortioxetine in a dosage of 10 mg/day.
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* Duloxetine is a strong an inhibitor of CYP2D6, which metabolizes vortioxetine.
* Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
* Patients could be directly switched from a SSRI or a SNRI to vortioxetine 10 mg/day. One week after initiation with vortioxetine, the dosage could be increased from 10 mg/day to 20 mg/day.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/25087600 Montgomery SA et al. A randomised, double-blind study in adults with major depressive disorder with an inadequate response to a single course of selective serotonin reuptake inhibitor or serotonin-noradrenaline reuptake inhibitor treatment switched to vortioxetine or agomelatine. Hum Psychopharmacol. 2014 Sep;29(5):470-82.]</ref>
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