Changing Antidepressants: How a Safe Switch Works
Based on Hope Integrative Medicine, Switching Antidepressants Safely
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How providers switch from Lexapro, Zoloft or Prozac to another antidepressant, when a cross-taper or washout is needed, and the warning signs to know.
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In this guide
Why People Switch
- Side effects
- It stopped working
- It never helped enough
Warning Signs
- Agitation, sweating or fever
- Fast heartbeat or muscle twitching
- Dizziness or brain zaps
After the Switch
- Four to eight weeks for full effect
- Follow up in two to four weeks
- In crisis? Call or text 988
What the guideline says
- Switching antidepressants is common when the first medicine causes side effects, stops working or never helps enough.
- A direct switch stops one medicine and starts the other the next day, and is often used between similar medicines such as escitalopram (Lexapro) and sertraline (Zoloft).
- A cross-taper lowers the first medicine over one to several weeks while raising the second, and is the most common approach, especially between different classes.
- Taper and wait, stopping the first medicine completely before starting the second, is required for some combinations, mainly moving to or from an MAOI.
- Overlapping serotonin medicines can rarely cause serotonin syndrome, which needs urgent care.
- The new medicine still needs four to eight weeks at a good dose for its full effect, so plan a follow-up visit two to four weeks after the switch.
Source: Hope Integrative Medicine, Switching Antidepressants Safely
Read the full article: Switching Antidepressants Safely: Direct Switch, Cross-Taper or Washout →
This guide is general health information and does not replace advice from your own provider.
Frequently Asked Questions
Plan a follow-up visit two to four weeks after the switch, so your prescriber can check how you are doing.
Agitation, sweating, fever, a fast heartbeat, muscle twitching or stiffness and diarrhea can be signs of serotonin syndrome, which is rare. Get urgent care for these.
If you are having thoughts of harming yourself, call or text 988 or call 911.