Switch medication from paroxetine to clomipramine.
- Before day 1: gradually reduce dosage of paroxetine to a maximum of 20 mg/day when this dosage is > 20 mg/day.
- Day 1: reduce dosage of paroxetine to a maximum of 10 mg/day.
- Day 8: stop administration of paroxetine.
Caution is necessary.
- Day 9: start administration of clomipramine in a low dosage of 25-50 mg/day.
- Day 16: increase dosage of clomipramine to 50-100 mg/day.
- Day 29: if necessary, increase dosage of clomipramine.
- Paroxetine slows the metabolism of clomipramine via CYP2D6.
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