Switching antidepressant (tricyclic antidepressants (TCA) to moclobemide) in adults

Switching antidepressant (tricyclic antidepressants (TCA) to moclobemide)

Taper, washout and switch

• for any TCA, you should gradually reduce the dose and stop. You will then need to wait for a period, dependent on the drug being switched from (see below), before starting moclobemide
• cross-tapering is not recommended due to the high risk of serotonin syndrome.

From TCAs other than clomipramine

After stopping the TCA, wait 7 days before starting moclobemide.

From clomipramine

After stopping clomipramine, wait 7 to 21 days before starting moclobemide. The manufacturer for clomipramine suggests a washout period of 21 days whereas other sources suggest shorter periods. Clinicians should decide the duration of the washout period on a case-by-case basis.

Reference:

• NHS Specialist Pharmacy Service (February 2023). Tricyclics to other antidepressants: switching in adults