Switching antidepressant (tricyclic antidepressants (TCA) to serotonin and noradrenaline reuptake inhibitors (SNRIs) (e.g. duloxetine or venlafaxine)) in adults
Switching antidepressant (tricyclic antidepressants (TCA) to serotonin and noradrenaline reuptake inhibitors (SNRIs))
From all except clomipramine
Cross-taper
- cross-tapering starting with a low dose SNRI can usually be undertaken cautiously over 2 to 4 weeks, the speed is determined by individual tolerability
From clomipramine
Taper, stop and switch
- if switching from clomipramine, gradually reduce the dose of clomipramine and stop. Start low dose SNRI the following day
- cross-tapering is not recommended and should only be undertaken if specialist advice is in place, this is because clomipramine is a potent serotonin reuptake inhibitor so there is a high risk of serotonin syndrome.
Reference:
- NHS Specialist Pharmacy Service (February 2023). Tricyclics to other antidepressants: switching in adults
Related pages
Create an account to add page annotations
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.