Antidepressant switching
Our advice on antidepressant switching guides on establishing whether a switch is necessary, choosing an antidepressant to switch to, agreeing a strategy, and monitoring. We also give advice on suitable strategies for a range of potential switches.
Establishing whether a person needs to switch their antidepressant
17 February 2023Prior response, side-effects, new contraindications, and current symptoms may make an antidepressant switch necessary. When it is, establish shared goals.
Choosing an antidepressant to switch a person to
17 February 2023Where a need to switch antidepressant is established, appraise the options to identify what's suitable for the person. For complex switches: consult an expert.
Planning and agreeing an antidepressant switching strategy
17 February 2023Where the need for an antidepressant switch is established and you've agreed with the individual what to switch to, you can then plan and implement the switch.
Monitoring a person during and after antidepressant switching
17 February 2023Review people at appropriate time points; advise on what to expect and report; and beware of the possibility of discontinuation and serotonin syndromes.
Switching strategies for antidepressants
22 May 2024
MAOI to other antidepressants: switching in adults
17 February 2023Switching between or from a monoamine oxidase inhibitor (MAOI) is always a complex switch and you should follow specialist advice.
Moclobemide to other antidepressants: switching in adults
17 February 2023How to switch safely from moclobemide to other antidepressants. Seek specialist advice for complex switches.
Trazodone to other antidepressants: switching in adults
17 February 2023How to switch safely from trazodone to other antidepressants. Seek specialist advice for complex switches.
Vortioxetine to other antidepressants: switching in adults
17 February 2023How to switch safely from vortioxetine to other antidepressants. Seek specialist advice for complex switches.
SNRIs to other antidepressants: switching in adults
17 February 2023How to switch safely between serotonin and noradrenaline reuptake inhibitors (SNRIs) or to other antidepressants. Seek specialist advice for complex switches.
Agomelatine to other antidepressants: switching in adults
17 February 2023How to switch safely from agomelatine to other antidepressants. Seek specialist advice for complex switches.
Mirtazapine to other antidepressants: switching in adults
17 February 2023How to switch safely from mirtazapine to other antidepressants. Seek specialist advice for complex switches.
Tricyclics to other antidepressants: switching in adults
17 February 2023How to switch safely between tricyclic antidepressants (TCAs) to other antidepressants or another TCA. Seek specialist advice for complex switches.
SSRIs to other antidepressants: switching in adults
17 February 2023How to switch safely between selective serotonin reuptake inhibitors (SSRIs) or to other antidepressants. Seek specialist advice for complex switches.
Other medicines switches
Switching between oral prednisolone and IV hydrocortisone
29 September 2023
Specific medicine switches for solid dose and liquid formulations
13 September 2023
Considerations when switching between solid doses and liquids
13 September 2023Practical advice when switching patients between liquid and tablet/capsule is provided to ensure adequate dose adjustments and monitoring.
Using amlodipine or MR felodipine for angina and hypertension
13 March 2023Guidance on choosing and switching between amlodipine and modified-release (MR) felodipine for angina and hypertension.
Switching between gabapentin and pregabalin for neuropathic pain
20 January 2023An overview of possible dose equivalences, switching methods and considerations to make before switching between gabapentinoids in adults with neuropathic pain.
Switching between imatinib preparations
15 December 2022Support for decision making when considering switching imatinib preparations including a locally adaptable patient information leaflet.
Switching between neostigmine and pyridostigmine
25 October 2022Switching between neostigmine and pyridostigmine requires care and application of a stepped process
Metolazone preparation differences and safety considerations
7 September 2022Healthcare professionals involved in the use of metolazone need to be aware of the differences between licensed and unlicensed products to ensure safe care
Switching doxazosin XL tablets to doxazosin standard tablets
12 May 2022Doxazosin XL tablets should not routinely be prescribed. Guidance is provided on switching doxazosin XL tablets to standard release tablets.
Switching between aminophylline and theophylline in adults
19 April 2022Intravenous aminophylline is used acutely for emergency respiratory conditions and we give a stepped approach on how to switch to oral theophylline