Advice for all antidepressants
You should read our advice for all antidepressant switching before applying that to individual agomelatine switches below.
- Establishing whether a person needs to switch their antidepressant
- Choosing an antidepressant to switch a person to
- Planning and agreeing an antidepressant switching strategy
- Monitoring a person during and after antidepressant switching
Agomelatine to mirtazapine
Direct switch
A direct switch, i.e. stopping one antidepressant and then starting the new antidepressant the following day, is normally possible.
Caution is required as there is limited experience with this switch although interactions are not expected. Abrupt withdrawal of agomelatine does not affect serotonin, noradrenaline, or dopamine and has not been associated with discontinuation symptoms. Since serotonin syndrome is unlikely, no dose tapering is needed.
Agomelatine to moclobemide
Direct switch
A direct switch, i.e. stopping one antidepressant and then starting the new antidepressant the following day, is normally possible.
Caution is required as there is limited experience with this switch although interactions are not expected. Abrupt withdrawal of agomelatine does not affect serotonin, noradrenaline, or dopamine and has not been associated with discontinuation symptoms. Since serotonin syndrome is unlikely, no dose tapering is needed.
Agomelatine to monoamine oxidase inhibitors (MAOI)
Switching to an MAOI is always a complex switch and you should follow specialist advice.
Direct switch with specialist advice
A direct switch, i.e. stopping one antidepressant and then starting the new antidepressant the following day, is normally possible.
Caution is required as there is limited experience with this switch although interactions are not expected. Abrupt withdrawal of agomelatine does not affect serotonin, noradrenaline, or dopamine and has not been associated with discontinuation symptoms. Since serotonin syndrome is unlikely, no dose tapering is needed.
Agomelatine to selective serotonin reuptake inhibitors (SSRIs)
Direct switch
A direct switch, i.e. stopping one antidepressant and then starting the new antidepressant the following day, is normally possible.
Caution is required as there is limited experience with this switch although interactions are not expected. Abrupt withdrawal of agomelatine does not affect serotonin, noradrenaline, or dopamine and has not been associated with discontinuation symptoms. Since serotonin syndrome is unlikely, no dose tapering is needed.
Agomelatine to serotonin and noradrenaline reuptake inhibitors (SNRIs)
Direct switch
A direct switch, i.e. stopping one antidepressant and then starting the new antidepressant the following day, is normally possible.
Caution is required as there is limited experience with this switch although interactions are not expected. Abrupt withdrawal of agomelatine does not affect serotonin, noradrenaline, or dopamine and has not been associated with discontinuation symptoms. Since serotonin syndrome is unlikely, no dose tapering is needed.
Agomelatine to trazodone
Direct switch
A direct switch, i.e. stopping one antidepressant and then starting the new antidepressant the following day, is normally possible.
Caution is required as there is limited experience with this switch although interactions are not expected. Abrupt withdrawal of agomelatine does not affect serotonin, noradrenaline, or dopamine and has not been associated with discontinuation symptoms. Since serotonin syndrome is unlikely, no dose tapering is needed.
Agomelatine to tricyclic antidepressants (TCAs)
Switching to dosulepin requires specialist advice and should not be done in primary care due to the increased cardiac risk and toxicity in overdose.
Direct switch
A direct switch, i.e. stopping one antidepressant and then starting the new antidepressant the following day, is normally possible.
Caution is required as there is limited experience with this switch although interactions are not expected. Abrupt withdrawal of agomelatine does not affect serotonin, noradrenaline, or dopamine and has not been associated with discontinuation symptoms. Since serotonin syndrome is unlikely, no dose tapering is needed.
Agomelatine to vortioxetine
Direct switch
A direct switch, i.e. stopping one antidepressant and then starting the new antidepressant the following day, is normally possible.
Caution is required as there is limited experience with this switch although interactions are not expected. Abrupt withdrawal of agomelatine does not affect serotonin, noradrenaline, or dopamine and has not been associated with discontinuation symptoms. Since serotonin syndrome is unlikely, no dose tapering is needed.
More advice on individual switches
We have further advice on how to switch between individual antidepressants of different types. Browse our collection below.
- MAOI to other antidepressants: switching in adults
- Moclobemide to other antidepressants: switching in adults
- Trazodone to other antidepressants: switching in adults
- Vortioxetine to other antidepressants: switching in adults
- SNRIs to other antidepressants: switching in adults
- Mirtazapine to other antidepressants: switching in adults
- Tricyclics to other antidepressants: switching in adults
- SSRIs to other antidepressants: switching in adults