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Approximate dose equivalent to fluoxetine 40 mg/day from randomized trials of antidepressants as monotherapy for unipolar depression[1]

Approximate dose equivalent to fluoxetine 40 mg/day from randomized trials of antidepressants as monotherapy for unipolar depression[1]
Antidepressant* Dose (mg/day)
Agomelatine (United States: Not available) 53
Amitriptyline 122
Bupropion 349
Clomipramine 116
Desipramine 196
Dothiepin (United States: Not available) 155
Doxepin 140
Escitalopram 18
Fluvoxamine 143
Imipramine 137
Lofepramine (United States: Not available) 250
Maprotiline (United States: Not available) 118
Mianserin (United States: Not available) 101
Mirtazapine 51
Moclobemide (United States: Not available) 575
Nefazodone 535
Nortriptyline 101
Paroxetine 34
Reboxetine (United States: Not available) 12
Sertraline 99
Trazodone 401
Venlafaxine 149

The doses listed here are not recommended for initiating therapy. Rather, the doses provide a starting point for the purpose of comparing and switching different antidepressants during maintenance therapy for unipolar depression. Dose equivalences are only one of several factors to consider for targeting a dose range when switching antidepressants; refer to UpToDate topic text.

The estimated dose equivalence will generally require rounding to the nearest available product strength(s), which can be found in the Lexicomp drug-specific monographs included within UpToDate.

MAOI: monoamine oxidase inhibitor.

* Dose equivalence for some antidepressants, such as citalopram and duloxetine, were not available. Citalopram is considered approximately one-half as potent as escitalopram; based on escitalopram equivalence data, citalopram 36 mg appears to be equivalent to fluoxetine 40 mg.

¶ Moclobemide is a reversible MAOI; switching to or from an MAOI requires specific precautionary measures. Refer to UpToDate text.
Data from:
  1. Hayasaka Y, Purgato M, Magni LR, et al. Dose equivalents of antidepressants: Evidence-based recommendations from randomized controlled trials. J Affect Disord 2015; 180:179.
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