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  1. The recommendations in this table are based on clinical experience, product information, empirical evidence and recommendations from other guidelines. It may be necessary to modify the switching process depending on patient, illness and interacting drug variables, determined by the patient’s clinical progress.

  2. Start mirtazapine at a low dose (e.g., 15 mg at bedtime).19,30 Or, taper fluoxetine to 20 mg once daily, then switch to mirtazapine 15 mg once daily [Evidence level B-1].20. Note that strong CYP2D6 inhibitors (e.g., bupropion, fluoxetine, paroxetine) can increase vortioxetine levels.

  3. Switches must be undertaken cautiously and under close observation. The recommendations in this table are based on clinical experience, product information, empirical evidence and recommendations from other guidelines.

  4. 27 Μαΐ 2011 · This can be very convenient and reduce any problems switching from one form of the drug to another. Switching to Prozac The risks of this method may not be worth switching from Lexapro to Prozac. This is usually used for medications with shorter half-lives than Lexapro.

  5. There is no single approach to switching antidepressants that can be applied to all patients, and published data on “optimal” switching strategy are scarce. Drugs with shorter half-lives will require longer taper periods than drugs with longer half-lives. You can get this document in other languages, large print, braille or a format you prefer.

  6. The purpose of this guidance is to advise clinicians about strategies to swap or stop antidepressants in primary or secondary care. It is a guide only and does not replace clinical judgement or a thorough assessment of the individual circumstances.

  7. Direct switch: stop the first antidepressant abruptly and start new antidepressant the next day. Taper & switch immediately: gradually taper the first antidepressant, then start the new antidepressant immediately after discontinuation.

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