switching antidepressants chart sinequan

The second antidepressant is then introduced according to the starting dose recommendations.Table 3 Guidelines for switching between specific antidepressantstaper and stop drug, then start fluoxetine at 10 mg§taper and stop drug, then start fluvoxamine at 50 mg§taper SSRI, start above drug at low dose (usually 25 mg)*taper and stop drug, then start clomipramine at 25 mg§taper and stop drug for 7 days washout before starting moclobemide at low dose§taper and stop drug for 7 days washout before starting MAOI at low dose§stop fluoxetine (or taper if dose >40 mg/day), wait 7 days for washout, then start above SSRI at low dose†§stop fluoxetine (or taper if dose >40 mg/day), wait 14 days for washout, then start fluvoxamine at 50 mg†§stop fluoxetine (or taper if dose >40 mg/day), wait 7 days for washout, then start vortioxetine at 5 mg†§stop fluoxetine (or taper if dose >40 mg/day), start agomelatinetaper and stop fluoxetine, wait 7 days for washout, then start SNRI at low dose†§stop fluoxetine (or taper if dose >40 mg/day), start above drug atstop fluoxetine (or taper if dose >40 mg/day), start reboxetine at 4 mg>40 mg/day), wait 14 days for washout, then start above drug at 25 mg and continue low dose for further 3 weeks‡stop fluoxetine (or taper if dose >40 mg/day), wait14 days for washout, then start clomipramine at 25 mg and continue this dose for further 3 weeks‡stop fluoxetine (or taper if dose >40 mg/day), thenwait 5–6 weeks for washout before cautiously commencing low‑dose moclobemide§stop fluoxetine (or taper if dose >40 mg/day), thenwait 5–6 weeks for washout before cautiously commencing low‑dose MAOI§taper and stop fluvoxamine, then start above SSRI at low dose§taper and stop fluvoxamine, then start fluoxetine at 10 mg§taper and stop fluvoxamine, start vortioxetine at 5 mg§taper and stop fluvoxamine, wait 7 days for washout, then start agomelatine§taper and stop fluvoxamine, then start SNRI at low dose§taper and stop fluvoxamine, then start above drug at low dose§taper and stop fluvoxamine, start clomipramine at 25 mg§taper and stop fluvoxamine, wait 7 days for washout before cautiously commencing low‑dose moclobemide§taper and stop fluvoxamine, wait 7 days for washout before cautiously commencing low‑ dose MAOI§taper and stop vortioxetine, start fluoxetine at 10 mg§taper and stop vortioxetine, start fluvoxamine at 50 mg§taper vortioxetine, start above drug at low dose (usuallytaper and stop vortioxetine, start clomipramine at 25 mg§taper and stop vortioxetine for 14 days washout before starting moclobemide at low dose§taper and stop vortioxetine for 21 days washout before starting MAOI at low dose cautiously§stop agomelatine, then start above drug at low dose (usually 25 mg)*taper and stop SNRI, wait 7 days for washout before cautiously commencing low‑dose moclobemide§taper and stop SNRI, wait 7 days for washout before cautiously commencing low‑dose MAOI§taper and stop drug, wait 7 days for washout before cautiously commencing low‑dose moclobemide§taper and stop drug, wait 14 days for washout before cautiously commencing low‑dose MAOI§taper and stop reboxetine, then wait 7 days for washout before cautiously commencing low‑dose moclobemide§taper and stop reboxetine, then wait 7 days for washout before cautiously commencing low‑dose MAOI§taper and stop first drug before starting fluoxetine§taper drug, start clomipramine cautiously at 25 mg*taper and stop drug, then wait 7 days for washout before starting moclobemide§taper and stop drug, then wait 14 days (21 days for imipramine) before starting MAOI§taper and stop clomipramine, then start above SSRI at low dose§taper and stop clomipramine, then start fluoxetine at 10 mg§taper and stop clomipramine, then start fluvoxamine at 50 mg§taper and stop clomipramine, then start vortioxetine at 5 mg§taper and stop clomipramine, then start SNRI at low dose§taper clomipramine, then start above drug at low dose*taper and stop clomipramine, then wait 7 days for washout before starting moclobemide§taper and stop clomipramine, then wait 21 days for washout before starting MAOI§taper and stop moclobemide, then wait 24 hours for washout before starting above drug§taper and stop moclobemide, then wait 24 hours for washout before starting fluoxetine§taper and stop moclobemide, then wait 24 hours for washout before starting fluvoxamine§taper and stop moclobemide, then wait 24 hours for washout before starting vortioxetine§taper and stop moclobemide, then wait 24 hours for washout before starting SNRI§taper and stop moclobemide, then wait 24 hours for washout before starting above drug§taper and stop moclobemide, then wait 24 hours for washout before starting reboxetine§taper and stop moclobemide, then wait 24 hours for washout before starting above drug§taper and stop moclobemide, then wait 24 hours for washout before starting clomipramine§taper and stop moclobemide, then wait 24 hours for washout before starting MAOI§taper and stop MAOI, then wait 14 days for washout before starting above drug§taper and stop MAOI, then wait 14 days for washout before starting fluoxetine§taper and stop MAOI, then wait 14 days for washout before starting fluvoxamine§taper and stop MAOI, then wait 14 days for washout before starting vortioxetine§taper and stop MAOI, then wait 14 days for washout before starting SNRI§taper and stop MAOI, then wait 14 days for washout before starting above drug§taper and stop MAOI, then wait 14 days for washout before starting reboxetine§taper and stop MAOI, then wait 14 days for washout before starting above drug§taper and stop MAOI, then wait 21 days for washout before starting clomipramine§taper and stop MAOI, start moclobemide while maintaining MAOI dietary restrictions fortaper and stop MAOI, wait 14 days for washout before starting other MAOI§Taper means gradual dose reduction, with lowering by increments every few days, usually over a period of 4 weeks, modified by patient experience, drug, illness and other factors.All switches from one antidepressant to another may result in serious complications.

In the indicated instances a washout period is not essential if switching is carried out cautiously and under close observation, and clinical considerations such as illness severity support harm–benefit considerations. The information provided herein should not be used for diagnosis or treatment of any medical condition. Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders. PsychedUp educational programs are developed by Dr. Diane McIntosh, the co-founder of SwitchRx.Presented by Dr. McIntosh, PsychedUp events are a full day of clinically relevant, practical, engaging, and interactive psychiatric education, focusing on diagnosis and treatment. ANTIDEPRESSANT COMPARISON CHART 1,2,3,4 NAME: Generic / TRADE RECEPTOR AFFINITY Citalopram CELEXA escitalopram LEXAPROUSA (20, 40mg scored tabs) abr=CC S(+) citalopram 10-20mg od Fluoxetine PROZAC (10,20mg cap & 4mg/ml solution) abr=F Fluvoxamine abr=X Paroxetine PAXIL (20,30mg tab), (10mg tab ) Sertraline abr=P SERZONE abr-Z (50,100,150,200mg tab) Reducing doses and discontinuation 6. The new drug might also have different side effects than the one you used to take. Switching antidepressants needs to be done carefully and with the help of your doctor.

Vortioxetine (an SSRI with possible other serotonergic effects) can interact with a variety of antidepressants. It may be necessary to modify the switching process depending on patient, illness and interacting drug variables, determined by the patient’s clinical progress.

Director, Centre for Mental Health Education and Research, Delmont Private HospitalDeputy director, Centre for Mental Health Education and Research, Delmont Private HospitalPsychiatrist and senior fellow, Centre for Mental Health Education and Research, Delmont Private HospitalReasonable care is taken to provide accurate information at the time of creation.

The risk of drug interactions is increased with this approach, but is still quite low.

Withdrawal syndromes occur with many drugs (such as corticosteroids) when used long term. Copyright 2016 Oxbridge Solutions Ltd®.

If you’ve been diagnosed with depression, your doctor will likely start you on a treatment plan of antidepressants like a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI). These strategies sometimes work — but not always.

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