Abstract:
Switching antidepressants because of lack of efficacy or unacceptable side-effects, while often required in general practice,
may result in toxic drug-drug interactions, worsening depression or unpleasant discontinuation reactions. Switching strategies
to minimise these risks include immediate switching, cross-tapering or incorporating a washout period. Immediate switching is
generally possible when substituting a selective serotonin reuptake inhibitor or a serotonin and noradrenaline reuptake inhibitor
for a drug from its own class. Cross-tapering over a period of weeks is preferred when switching between different antidepressant
classes or from high-dose antidepressants. Dangerous interactions necessitate the observance of an adequate washout period
when switching to and from monoamine oxidase inhibitors.
