Switch medication from citalopram to fluoxetine.
- Before day 1: gradually reduce dosage of citalopram to a maximum of 20 mg/day, when this dosage is > 20 mg/day.
- Day 1: reduce dosage of citalopram to a maximum of 10 mg/day.
- Day 8: stop administration of citalopram
- No wash-out period is needed.
- Day 9: start fluoxetine in normal dosage of 20 mg/day.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
- Fluoxetine slows the metabolism of citalopram by inhibition of CYP2C19, CYP2D6 and CYP3A4
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