Depression Treatment Medication How to Switch to a New Antidepressant Safely By Sanjana Gupta Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness. Learn about our editorial process Published on March 31, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Daniel B. Block, MD Medically reviewed by Daniel B. Block, MD LinkedIn Twitter Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Print SDI Productions / Getty Images Table of Contents View All Table of Contents What to Consider Strategies to Switch Side Effects Safety If you have been diagnosed with a mental health condition such as depression, your healthcare provider may prescribe antidepressant medication to help treat it. These medications work by rebalancing some of the chemicals in your brain, known as neurotransmitters. There are several different types of antidepressant medications and it’s important to find the one that works best for you. According to a 2016 study, up to two-thirds of people who have depression don’t respond to the first antidepressant drug they are prescribed and need to change their medication before they see results. As the different types of antidepressants work in different ways, there are multiple techniques to switch antidepressants, depending on what you are taking, says Jeffrey Zabinski, MD, a psychiatrist at Columbia University Medical Center. It’s important to switch antidepressant medications carefully and in coordination with your psychiatrist, to minimize the risk of uncomfortable side effects, medication interactions, or worsening symptoms, says Dr. Zabinski. This article explores the different strategies healthcare providers use while switching antidepressants, in order to minimize risks and side effects. Factors to Consider While Switching Antidepressants According to Dr. Zabinski, these are some of the factors your healthcare provider will take into consideration while switching your antidepressant medication: The type of antidepressant you are currently taking The type of antidepressant you will be switching to The dosage of medication you are taking The amount of time you have been taking the medication The severity of your condition and the symptoms you’re experiencing The severity of the side effects you are experiencing, if any Any other medication you are taking and any potential drug interactions How to Know Which Antidepressant Is Best for You Strategies to Switch Antidepressants These are some of the strategies that your healthcare provider might employ while changing your medication: Direct switch: This method involves stopping your current medication and starting the new medication from the next day onward. As the quickest and simplest way to switch medications, this method can only be used in certain circumstances, such as when you haven’t been on your current medication for very long or are switching between drugs that work in similar ways. Taper and immediate switch: This method involves gradually reducing the dosage of your current medication and then switching to the other. This strategy takes longer than the direct switch but may be required if you have been taking your present medication for over six weeks, as you may face discontinuation effects if you stop taking it abruptly. Taper, washout, and subsequent switch: This method is used for certain types of medications that require more time and care, says Dr. Zabinski. It involves decreasing and then stopping one medication, waiting for a period of time until it’s out of your system, and then starting the other medication, explains Dr. Zabinski. Using this method can help prevent the two drugs from interacting with each other and potentially causing harmful side effects. Cross taper: This is the most common method and involves gradually decreasing one medicine while gradually increasing the other, says Dr. Zabinski. It is not usually safe to just stop taking your antidepressant on your own without first consulting your psychiatrist and exploring the range of options, explains Dr. Zabinski. “If you were to stop taking medication suddenly, your risk for having worse anxiety and depression symptoms increases significantly.” Side Effects of Switching Antidepressants When you’re switching between antidepressant medications, you may face side effects because your body may have gotten used to the previous medication, especially if you’ve been taking it for over four to six weeks. Therefore, discontinuing it can lead to a type of withdrawal known as antidepressant discontinuation syndrome. Most of the potential side effects are uncomfortable, but not dangerous or life-threatening, says Dr. Zabinski. They may start within two to four days of stopping or tapering off the medication and last for a week or two. The symptoms of antidepressant discontinuation syndrome can include: Digestive issues, such as nausea, vomiting, diarrhea, stomach cramps, or loss of appetite Balance issues, such as dizziness or lightheadedness Sleep difficulties, such as difficulty sleeping or nightmares Movement control issues, such as tremors, restless legs, difficulty chewing, or trouble speaking Mood issues, such as anxiety, mania, depression, irritability, agitation, paranoia, confusion, or suicidal thoughts Flu-like symptoms, such as tiredness, headache, or muscle pain Electrical sensations in the brain, sometimes known as brain zaps, although this only happens in rare cases, according to Dr. Zabinski In addition, starting the new antidepressant can also cause side effects such as weight gain, fatigue, dry mouth, increased heart rate, and sexual dysfunction. Switching Antidepressants Safely Switching antidepressants is a process that must be approached carefully and under close medical observation. Dr. Zabinski shares some steps that can help you make the transition safely: Find out what to expect: Ask your psychiatrist about what to expect when you switch antidepressants and what you should do if any symptoms arise. Check-in regularly: Your psychiatrist may require you to visit more frequently while you’re in the process of switching antidepressants. Make it a point to check in with them regularly and don’t miss any of your follow-up appointments. Report any side effects: If you experience any side effects, discuss them with your doctor. You may need to work together to change the strategy for switching antidepressants, or slow the process down so that you are more comfortable. Be prepared for emergencies: If you have depression that gets significantly worse during a medication switch, it may lead to a mental health crisis, which would require emergency care. Inform trusted loved ones that you’ll be changing your medication, tell them what symptoms to look out for, and work on a plan in case of emergencies. It can be helpful to run this plan by your healthcare provider too. Is It Possible to Overdose on Antidepressants? A Word From Verywell You may need to switch your antidepressant if it’s not helping your symptoms or giving you severe side effects. However, it’s not advisable to simply stop taking your medication or switching to another one without consulting your healthcare provider. You need to inform your healthcare provider about the symptoms you’re experiencing and work with them to develop a strategy to help you switch your medication. It’s important to follow your psychiatrist’s instructions while you’re making the switch, because otherwise you may be more likely to experience side effects, worsening symptoms, or medication interactions, says Dr. Zabinski. 6 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. University of Michigan. Antidepressant withdrawal. Keks N, Hope J, Keogh S. Switching and stopping antidepressants. Aust Prescr. 2016;39(3):76-83. doi:10.18773/austprescr.2016.039 Henssler J, Heinz A, Brandt L, Bschor T. Antidepressant withdrawal and rebound phenomena. Dtsch Arztebl Int. 2019;116(20):355-361. doi:10.3238/arztebl.2019.0355 Gabriel M, Sharma V. Antidepressant discontinuation syndrome. CMAJ. 2017;189(21):E747. doi:10.1503/cmaj.160991 Harvard Medical School. Going off antidepressants. Harvard Health Publishing. American Academy of Family Physicians. How to safely take antidepressants. By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.