Fluoxetine-clomipramine

Fluoxetine
Type Antidepressant
Group SSRI
links
Medscape Fluoxetine
PubChem 3386
PubMed Fluoxetine
Kompas (Dutch) Fluoxetine
Wikipedia Fluoxetine
Clomipramine
Type Antidepressant
Group TCA
links
ATC-code N06AA04
Medscape Clomipramine
PubChem 2801
PubMed Clomipramine
Kompas (Dutch) Clomipramine
Wikipedia Clomipramine

Switch medication from fluoxetine to clomipramine.

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 clomipramine

Caution is necessary for at least four weeks.

  • Day 2: start administration of clomipramine in a low dosage of 25 mg/day.
  • Day 9: increase dosage of clomipramine to 50 mg/day.
  • Day 29: gradually increase dosage of clomipramine to 75 mg/day and more.
Infobord.png More information
  • Fluoxetine and norfluoxetine slow the metabolism of clomipramine via CYP2D6.
  • Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
  • Start low, go slow for clomipramine.
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