Switch medication from amitriptyline to trazodone.
- Before day 1: gradually reduce dosage of amitriptyline to a maximum of 50-100 mg/ day, when this dosage is > 100 mg/day.
- Day 1-3: reduce dosage of amitriptyline to 50 mg/day.
- Day 4-7: reduce dosage of amitriptyline to 25 mg/day.
- Day 8: stop administration of amitriptyline.
No wash-out period is needed.
- Day 4: simultaneously start administration of trazodone in a dosage of 150 mg/day.
- Day 12: if necessary, increase the dosage of trazodone to a maximum of 400 mg/day.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
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