- Day 1: Stop fluoxetine
- Day 5: Start with 50% of the target dose
- Day 10: Increase dose to 100% of the target dose
- Day 11 and after: Gradually increase dose as necessary
- Fluoxetine and its metababolite desmethyl-fluoxetine have a very long elimination time of about 1 week; phasing out fluoxetine is therefore not necessary.
- Fluoxetine slows the metabolism of trazodone via CYP2D6, so caution is necessary for at least four weeks.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Safe target dose of trazodon as antidepressant = 150 mg
- Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
- Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
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