Switch medication from escitalopram to imipramine.
- Before day 1: gradually reduce dosage of escitalopram to a maximum of 10 mg/day, when this dosage is >10 mg/day.
- Day 1: reduce dosage of escitalopram to a maximum of 5 mg/day.
- Day 8: stop administration of escitalopram.
- Day 9: no wash-out period is needed. Start administration of imipramine in a low dosage of 25 mg/day.
- Day 16: increase dosage of imipramine.
- Start low, go slow.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
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