Medications - SSRIs

Question 1

Setraline
-starting dose
-how to uptitrate dose
-max dose

Answer 1

50mg PO OD

Can increase dose by 50mgs at minimum weekly intervals - adjust in relation to side effects and mood effects

Max dose - 200mg

Question 2

Switches between
-citalopram, escitalopram, setraline, paroxetine => SSRI
-fluoxetine => SSRI
-SSRI => TCA
-citalopram, escitalopram, sertraline, paroxetine => venlafaxine
-fluoxetine => venlafaxine

Answer 2

Direct switch is possible
-if Hx of cardiac disease => ECG needed before citalopram/escitalopram started

Gradually decrease then leave gap of 4-7 days (long T1/2) => start low dose of SSRI

Cross taper
-reduce SSRI dose slowly whilst increasing TCA slowly
UNLESS FLUOXETINE - leave 4-7 day gap before starting TCA

Direct switch is possible

Withdraw => 4-7 day gap => start low dose venlafaxine