Essentials of Psychiatry in Primary Care: Behavioral Health in the Medical Setting >Major Depression and

Related Disorders
Robert C. Smith, Gerald G. Osborn, Francesca C. Dwamena, Dale D'Mello, Laura Freilich, Heather S. Laird-Fick+
Table 4-8.Switching Antidepressants

Switching From Switching To

Tricyclic SSRI or SNRI Taper over 5-7 d; start new drug 2-3 d later

Taper over 2-5 d, then start SNRI; use lower dose if switch from
SSRI SNRI fluoxetine; longer taper if high doses fluoxetine; monitor serotonin
syndrome

Taper over 2-5 d, then start SSRI; use lower dose if switch from
SSRI Different SSRI fluoxetine; longer taper if high doses fluoxetine; monitor serotonin
syndrome

SNRI SSRI Taper over 2-5 d; then start SSRI

SNRI Different SNRI Taper over 2-5 d; then start new

Mirtazapine Other drugs Taper over 2-5 d; then start new

Other drugs mirtazapine Taper over 2-5 d; then start new

Taper over 1 wk; start new drug as usual the same time starting
Bupropion Other drugs
taper

Taper over 1-2 wk (2-3 for SNRI); gradually increase dose of

Other drugs Bupropion
bupropion during this time

SNRI = serotonin-norepinephrine reuptake inhibitor; SSRI = selective serotonin reuptake inhibitor.

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