Fluoxetine-amitriptyline

Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine
Amitriptyline
Type Antidepressant
Group TCA
links
ATC-code N06AA09
Medscape Amitriptyline
PubChem 2160
PubMed Amitriptyline
Kompas (Dutch) Amitriptyline
Wikipedia Amitriptyline

Switch medication from fluoxetine to amitriptyline.

Nietinrijdenbord.png Stop fluoxetine
  • Before day 1: reduce dosage of fluoxetine with about 20 mg per week.
  • Day 1: when a dosage of 20 mg/day is reached, stop fluoxetine.
Eenrichtingbord.png Start amitriptyline

Caution is necessary for at least four weeks.

  • Day 2: start administration of amitriptyline in a low dosage of 25 mg/day.
  • Day 15: increase dosage of amitriptyline to 50 mg/day.
  • Day 29: gradually increase dosage of amitriptyline.
Infobord.png More information
  • Fluoxetine and norfluoxetine slow the metabolism of amitriptyline via CYP2D6.
  • Start low, go slow for amitriptyline.
  • Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
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