switching antidepressant (SSRIs to mirtazapine) in adults
Last edited 03/2023 and last reviewed 03/2023
SSRIs to mirtazapine
Cross-taper
- cross-tapering can generally be undertaken cautiously over 2 to 4 weeks, the speed is determined by individual tolerability
- fluoxetine may still cause medicine interactions 5 or 6 weeks after stopping, as fluoxetine and its active metabolite have a long half-life
- start mirtazapine at a dose of 15mg daily.
- this caution is required because fluvoxamine is a potent inhibitor of the liver enzyme CYP1A2 which is involved in the metabolism of mirtazapine
- is therefore a risk of raised mirtazapine levels in the body when they are administered together
- this caution is required because fluvoxamine is a potent inhibitor of the liver enzyme CYP1A2 which is involved in the metabolism of mirtazapine
Reference:
- NHS Specialist Pharmacy Service (February 2023). SSRIs to other antidepressants: switching in adults