Switch medication from vortioxetine to duloxetine.
- Day 1: reduce dosage of vortioxetine to 5 mg/day.
- Day 8: stop administration of vortioxetine.
- Day 8-14: a wash-out period of 1 week is necessary.
- Day 15: start administration of duloxetine in a dosage of 30 mg/day.
- Day 22: bloodlevel vortioxetine is now zero, so you can increase faster.  
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Duloxetine is a inhibitor of CYP2D6, which metabolizes vortioxetine.
- Katona et al. New generation multi-modal antidepressants: focus on vortioxetine for major depressive disorder. 2014 2014 Feb 19;10:349-54
- KNMP; Informatorium Medicamentorum 2015; Monografie "vortioxetine" (Dutch)
- European Medicines Agency | SmPC Brintellix 5 mg.
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