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

Switching antidepressant (tricyclic antidepressants (TCA) to another TCA)

• switching to dosulepin requires specialist advice and should not be done in primary care due to the increased cardiac risk and toxicity in overdose.

From all except clomipramine

Direct switch

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

From clomipramine

Cross-taper

• cross-tapering can usually be undertaken cautiously over 2 to 4 weeks, the speed is determined by individual tolerability

Reference:

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