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Switching antidepressant (SSRIs to another SSRI) in adults

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SSRIs to another SSRI

From all except fluoxetine

Direct switch

  • a direct switch, i.e. stopping one antidepressant and then starting the new antidepressant the following day, is normally possible

From fluoxetine

  • Taper, washout and switch
    • gradually reduce the dose of fluoxetine to 20mg daily and stop; wait 4 to 7 days before starting low dose SSRI
    • clinicians should decide the duration of the washout period on a case-by-case basis

  • fluoxetine may still cause medicine interactions 5 or 6 weeks after stopping, as fluoxetine and its active metabolite have a long half-life

Reference:


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