Switch medication from paroxetine to vortioxetine.
- Day -7: reduce dosage of paroxetine to 20 mg/day, if this dosage is > 20 mg/day.
- Day 0: dosage of paroxetine is 20 mg/day.
- Day 1: reduce dosage of paroxetine to 10 mg/day.
- Day 8: reduce dosage of paroxetine to 5 mg/day.
- Day 15: stop administration of paroxetine.
- Day 15-18: a wash-out period of 3 days is to prevent inhibition of the metabolism of vortioxetine.
- Day 18: start administration of vortioxetine in a normal dosage of 10 mg/day.
- Paroxetine is a strong inhibitor of CYP2D6, which metabolizes vortioxetine.
- Occurrence of serotonin syndrome is theoretically possible, so caution is necessary.
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