{"id":11425,"date":"2020-05-20T09:00:30","date_gmt":"2020-05-20T13:00:30","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=11425"},"modified":"2025-09-03T12:09:23","modified_gmt":"2025-09-03T16:09:23","slug":"switching-antidepressants","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/switching-antidepressants\/","title":{"rendered":"What you should know before switching antidepressants"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">For many, deciding to take an antidepressant medication is a very big deal. You spend a lot of time thinking about it, weighing the pros and cons, and <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/ask-a-doctor-about-antidepressants\/\"><span style=\"font-weight: 400;\">talking to your healthcare provider about options<\/span><\/a><span style=\"font-weight: 400;\">, before deciding to try a prescription medication.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Finding the <\/span><i><span style=\"font-weight: 400;\">right<\/span><\/i><span style=\"font-weight: 400;\"> antidepressant can require some trial and error, some fine-tuning. You may have to change medications at some point to find one that works well for you. If you\u2019re concerned that your current prescription isn\u2019t as effective as it should be, talk to your doctor about switching antidepressants.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/drug-classes\/antidepressants\"><b>List of antidepressants<\/b><\/a><\/p>\n<h2><span style=\"font-weight: 400;\">Common reasons for switching antidepressants<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">How do you know if you need to change your antidepressant? One of the most common reasons that people switch antidepressants is that they feel their current medication isn\u2019t really helping them. Antidepressants can be ineffective in a variety of ways.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">1. Time<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Antidepressants need time to reach their maximum effectiveness. The length of time can vary.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Six weeks can usually provide insight, one way or another, suggests <\/span><a href=\"https:\/\/www.wbma.cc\/gonzalo-laje\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Gonzalo Laje, MD<\/span><\/a><span style=\"font-weight: 400;\">, MHSc, director at Washington Behavioral Medicine Associates and clinical associate professor at George Washington University.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">2. Dosage<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If an antidepressant isn\u2019t working after approximately six weeks, it could be that the dose is too low. Consult your healthcare provider, who can slowly and carefully increase the dose. If you\u2019re not feeling better when taking a higher (or even the maximum) dose, it might be time to discuss trying something else\u2014or adding another medication.\u00a0\u00a0<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">3. Side effects<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Not everyone experiences side effects, and some people are willing to tolerate certain <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/side-effects-of-antidepressants\/\"><span style=\"font-weight: 400;\">side effects<\/span><\/a><span style=\"font-weight: 400;\"> from medication if it\u2019s helping their depression. But for other people,<\/span> <span style=\"font-weight: 400;\">side effects like a<\/span>\u00a0<a href=\"https:\/\/www.singlecare.com\/blog\/sex-on-ssris\/\"><span style=\"font-weight: 400;\">low libido<\/span><\/a><span style=\"font-weight: 400;\">, dry mouth, or nausea are deal breakers. If you\u2019re struggling to cope with the side effects, it may be time to schedule an appointment with your healthcare provider.\u00a0\u00a0<\/span><\/p>\n<p><b>Don\u2019t try stopping or changing medications on your own.<\/b><span style=\"font-weight: 400;\"> You might experience some withdrawal symptoms, especially if you stop abruptly. \u201cIt\u2019s always better to talk to your doctor about (making) these changes,\u201d Dr. Laje says. <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/side-effects-of-antidepressants\/\"><span style=\"font-weight: 400;\">Withdrawal symptoms of antidepressants<\/span><\/a><span style=\"font-weight: 400;\"> typically include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Anxiety<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Trouble sleeping<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">\u201cHead buzzing\u201d<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Headaches<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fatigue<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Flu-like symptoms<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Irritability<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\t\t<div class=\"singlecare-dynamic-newsletter-wrapper sin-newsletter-wrapper\">\n\t\t\t<span class=\"heading\">Get our mental health newsletter<\/span>\n\t\t\t<form class=\"form-wrapper\" data-newsletter-form=\"1\" data-subsource=\"Mental Health Newsletter\">\n\t\t\t\t<div class=\"input-wrapper\">\n\t\t\t\t\t<label for=\"dynamic-email\">Email<\/label>\n\t\t\t\t\t<input type=\"email\" id=\"dynamic-email\" class=\"email\" required>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"input-wrapper\">\n\t\t\t\t\t<input class=\"submit-form-btn\" type=\"submit\" value=\"Click to sign up\">\n\t\t\t\t<\/div>\n\t\t\t<\/form>\n\t\t\t<p class=\"success-message\" aria-live=\"polite\"><\/p>\n\t\t<\/div>\n\t<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Choosing a new antidepressant that is best for you<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Then the question becomes: What is the best medication to switch to? There are many potential choices from these <\/span><a href=\"https:\/\/www.fda.gov\/consumers\/free-publications-women\/depression-medicines\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">categories of antidepressants<\/span><\/a><span style=\"font-weight: 400;\">:<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/ssris\"><b>Selective serotonin reuptake inhibitors (SSRIs)<\/b><\/a><b>:<\/b><span style=\"font-weight: 400;\"> This category includes commonly prescribed medications like <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/prozac\"><span style=\"font-weight: 400;\">Prozac<\/span><\/a><span style=\"font-weight: 400;\"> (fluoxetine), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/celexa\"><span style=\"font-weight: 400;\">Celexa<\/span><\/a><span style=\"font-weight: 400;\"> (citalopram), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/lexapro\"><span style=\"font-weight: 400;\">Lexapro<\/span><\/a><span style=\"font-weight: 400;\"> (escitalopram), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/paxil\"><span style=\"font-weight: 400;\">Paxil<\/span><\/a><span style=\"font-weight: 400;\"> (paroxetine), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/zoloft\"><span style=\"font-weight: 400;\">Zoloft<\/span><\/a><span style=\"font-weight: 400;\"> (sertraline), and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/viibryd\"><span style=\"font-weight: 400;\">Viibryd<\/span><\/a><span style=\"font-weight: 400;\"> (vilazodone).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/snris\"><b>Serotonin and norepinephrine reuptake inhibitors (SNRIs):<\/b><\/a><span style=\"font-weight: 400;\"> This category includes <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/effexor-xr\"><span style=\"font-weight: 400;\">Effexor XR<\/span><\/a><span style=\"font-weight: 400;\"> (venlafaxine), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/pristiq\"><span style=\"font-weight: 400;\">Pristiq<\/span><\/a><span style=\"font-weight: 400;\"> (desvenlafaxine), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/cymbalta\"><span style=\"font-weight: 400;\">Cymbalta<\/span><\/a><span style=\"font-weight: 400;\"> (duloxetine), and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/fetzima\"><span style=\"font-weight: 400;\">Fetzima<\/span><\/a><span style=\"font-weight: 400;\"> (levomilnacipran).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Tricyclic antidepressants (TCAs):<\/b><span style=\"font-weight: 400;\"> TCAs are an older category of antidepressant with more side effects than newer antidepressants. This class includes drugs such as Tofranil (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/imipramine-hcl\"><span style=\"font-weight: 400;\">imipramine<\/span><\/a><span style=\"font-weight: 400;\">), Elavil (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/amitriptyline-hcl\"><span style=\"font-weight: 400;\">amitriptyline<\/span><\/a><span style=\"font-weight: 400;\">), <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/pamelor\"><span style=\"font-weight: 400;\">Pamelor<\/span><\/a><span style=\"font-weight: 400;\"> (nortriptyline), and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/norpramin\"><span style=\"font-weight: 400;\">Norpramin<\/span><\/a><span style=\"font-weight: 400;\"> (desipramine).<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/drug-classes\/maois\"><b>Monoamine oxidase inhibitors (MAOIs):<\/b><\/a><span style=\"font-weight: 400;\"> MAOIs are another older category of medication not used as first-line treatments anymore, and include <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/nardil\"><span style=\"font-weight: 400;\">Nardil<\/span><\/a><span style=\"font-weight: 400;\"> (phenelzine) and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/parnate\"><span style=\"font-weight: 400;\">Parnate<\/span><\/a><span style=\"font-weight: 400;\"> (tranylcypromine)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Other antidepressants:<\/b><span style=\"font-weight: 400;\"> This category includes medications that may not fit precisely into another category, such as Wellbutrin (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/bupropion-hcl\"><span style=\"font-weight: 400;\">bupropion<\/span><\/a><span style=\"font-weight: 400;\">), which is a norepinephrine-dopamine reuptake inhibitor (NDRI), and Desyrel (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/trazodone-hcl\"><span style=\"font-weight: 400;\">trazodone<\/span><\/a><span style=\"font-weight: 400;\">), which is known as a serotonin antagonist and reuptake inhibitor (SARI).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">All antidepressants come with benefits and downsides, so it may become a question of what works well for you. \u201cWe usually go for something that has the least amount of side effects in general,\u201d says psychiatrist <\/span><a href=\"http:\/\/psychiatry.med.miami.edu\/faculty\/clinical-faculty\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Samuel Mowerman, MD<\/span><\/a><span style=\"font-weight: 400;\">, faculty member at the University of Miami Miller School of Medicine.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">According to Dr. Mowerman, the features of your particular kind of depression will also affect the choice. For example, if you also <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/anxiety-treatment-and-medications\"><span style=\"font-weight: 400;\">live with anxiety<\/span><\/a><span style=\"font-weight: 400;\">, your doctor might recommend an <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medication-for-anxiety-and-depression\/\"><span style=\"font-weight: 400;\">antidepressant with a success rate for addressing anxiety<\/span><\/a><span style=\"font-weight: 400;\">, too.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Your doctor may choose to switch you from one category of antidepressant to another. Or your doctor might suggest that you stick with a medication from the same category of drug that you\u2019ve been taking. For example, if you\u2019re already taking one SSRI, your doctor might suggest trying another one, like <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/zoloft-vs-prozac\/\"><span style=\"font-weight: 400;\">switching from Prozac to Zoloft<\/span><\/a><span style=\"font-weight: 400;\"> or <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/lexapro-vs-zoloft\/\"><span style=\"font-weight: 400;\">switching from Lexapro to Zoloft<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/resources\/antidepressants\">Save on common antidepressants<\/a><\/p>\n<h2><span style=\"font-weight: 400;\">How to switch antidepressants<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">When you do make the switch, there are several possible processes for doing it:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Cross-tapering:<\/b><span style=\"font-weight: 400;\"> You decrease the original medication dose while starting the new medication at a low dose and gradually increasing it.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Direct switch:<\/b><span style=\"font-weight: 400;\"> This could involve stopping the old drug and then starting the new one on the following day.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Taper down and stop, before starting the new drug:<\/b><span style=\"font-weight: 400;\"> You gradually decrease the amount of your original antidepressant, then start taking the new medication immediately after stopping the original medication.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><b>Taper, washout, and switch. <\/b><span style=\"font-weight: 400;\">You gradually decrease the amount of your original antidepressant, then stop taking it altogether. Your healthcare provider will advise a \u201cwashout period\u201d of days or weeks to wait before starting the new medication.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u201cMAOIs and tricyclics are two classes of antidepressants that should be tapered off first with time for the blood levels to go to zero before starting a new antidepressant,\u201d Dr. Israel says.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">More about cross-tapering<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Cross-tapering is a standard approach in many cases, says psychiatrist <\/span><a href=\"https:\/\/successtms.com\/about\/team\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Lindsay Israel, MD<\/span><\/a><span style=\"font-weight: 400;\">, chief medical officer at Success TMS. For example, it\u2019s often used when you switch from an SSRI to a drug in another class. Why? Because it takes time for the original medication to leave your system, just as it takes a while for the new medication to take effect.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">A cross-taper allows you to gradually ramp up the new med while slowly decreasing the original one, which should help to minimize any symptoms of what Israel calls \u201cdiscontinuation syndrome\u201d due to any overlap, especially if the medications have similar properties, says Dr. Israel.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Common symptoms of <\/span><a href=\"https:\/\/www.health.harvard.edu\/blog\/discontinuation-syndrome-and-antidepressants-2019040416361\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">discontinuation syndrome<\/span><\/a><span style=\"font-weight: 400;\"> include fatigue, nausea, insomnia, vertigo, dizziness, and fogginess.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\">How long does it take to adjust to a new antidepressant?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">It depends in part on the dosage you have been taking. A higher dose may take a little longer. \u201cDepending on the half-life of the medications in question and the current dosage, this cross-taper can take anywhere from one week to four to six weeks,\u201d Dr. Israel says.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Side effects of switching antidepressants<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">As previously mentioned, you may experience symptoms of withdrawal or discontinuation syndrome.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It\u2019s also important to note symptoms of serotonin syndrome, which is a life-threatening condition that can happen when you take more than one antidepressant medication (or more than one medication, antidepressant or other) that affects serotonin levels. Serotonin syndrome requires emergency medical attention. <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/serotonin-syndrome-symptoms\/\"><span style=\"font-weight: 400;\">Symptoms of serotonin syndrome<\/span><\/a><span style=\"font-weight: 400;\"> include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Mood changes, agitation, or anxiety<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Restlessness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Confusion<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Muscle changes, such as lack of coordination, stiffness, rigidity, or muscle jerks (especially in the legs)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sweating, shivering, flushed skin, fever, or hyperthermia<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increased heart rate or blood pressure<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea, vomiting, diarrhea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tremor<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hyperactive reflexes<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dilated pupils<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">You should also be aware of the side effects to expect from your new antidepressant, as they may differ from those of the original antidepressant. Ask your healthcare provider or pharmacist for a complete list of side effects associated with the new medication.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Are antidepressants worth switching?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Ultimately, the goal of switching antidepressants is to find a medication that works for you.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Mowerman\u2019s advice: \u201cGive it time.\u201d Let the new medication work, he adds. It may take some time to ramp up to the dose that\u2019s most effective for you, or to find the right medication. Don\u2019t give up if you don\u2019t feel great right away or have to try a few prescriptions.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">And don\u2019t be afraid to speak up. If you have any questions or concerns about side effects, be sure to ask. For example, don\u2019t be embarrassed to raise any concerns about the<\/span> <a href=\"https:\/\/www.singlecare.com\/blog\/sex-on-ssris\/\"><span style=\"font-weight: 400;\">effect of an antidepressant on your sex drive<\/span><\/a><span style=\"font-weight: 400;\">, Dr. Mowerman says. They\u2019re real and valid concerns.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>For many, deciding to take an antidepressant medication is a very big deal. You spend a lot of time thinking about it, weighing the pros and cons, and talking to your healthcare provider about options, before deciding to try a prescription medication. Finding the right antidepressant can require some trial and error, some fine-tuning. You [&hellip;]<\/p>\n","protected":false},"author":93,"featured_media":51112,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[451,450],"coauthors":[9482],"class_list":["post-11425","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-depression","tag-mental-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What to expect when switching antidepressants<\/title>\n<meta name=\"description\" content=\"Thinking about switching antidepressants? 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