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Switching antidepressant medications in adults

Michael Hirsch, MD
Robert J Birnbaum, MD, PhD
Section Editor
Peter P Roy-Byrne, MD
Deputy Editor
David Solomon, MD


When patients respond poorly to an antidepressant medication or exhibit intolerable side effects, and switching to another antidepressant is indicated, clinicians should be familiar with the pharmacology of each drug, the potential for drug-drug interactions and discontinuation symptoms, and the time to onset of effectiveness of the new medication.  

Switches from one antidepressant to another are common. A study of an administrative claims database found that among patients (n >130,000) who started antidepressant monotherapy for a new episode of depression, switching occurred in 9 percent [1].

This topic discusses switching from one antidepressant drug to another. Discontinuing antidepressants without switching to another drug and choosing a specific antidepressant regimen for the initial treatment of depression or for treatment resistant depression are discussed separately, as are the pharmacology, administration, and side effects of antidepressants.

(See "Discontinuing antidepressant medications in adults".)

(See "Unipolar major depression in adults: Choosing initial treatment".)

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Literature review current through: Nov 2017. | This topic last updated: Nov 16, 2017.
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  2. American Psychiatric Association. Practice Guideline for the Treatment of Patients with Major Depressive Disorder, Third Edition. October, 2010. http://psychiatryonline.org/guidelines (Accessed on November 06, 2015).
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