Switch medication from escitalopram to dosulepine.
- Before day 1: gradually reduce dosage of escitalopram to a maximum of 10 mg/day, when this dosage is >10 mg/day.
- Day 1: reduce dosage of escitalopram to a maximum of 5 mg/day.
- Day 8: stop administration of escitalopram.
- Day 9: start administration of dosulepine in a normal dosage of 50-75 mg/day.
- Day 16: increase dosage of dosulepine if necessary.
- “Start low, go slow” for dosulepine is not required, but caution is necessary.
- Occurrence of the serotonin syndrome is not likely, but theoretically possible, so caution is necessary.
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