Antidepressants, a Guide to Switching and Withdrawing

Instructions for changing or stopping antidepressants.

Check at a glance how to change or discontinue antidepressant treatment with the MIMS guide to switching and withdrawing antidepressants.

The tabulated quick-reference guide provides recommendations for patients receiving or switching to:

  • Monoamine oxidase inhibitors (MAOIs), both reversible (moclobemide) and irreversible (phenelzine and tranylcypromine)
  • The noradrenaline reuptake inhibitor reboxetine
  • Serotonin-noradrenaline reuptake inhibitors (SNRIs): duloxetine and venlafaxine)
  • Selective serotonin reuptake inhibitors (SSRIs): citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline
  • Tricyclic antidepressants (amitriptyline, clomipramine, dosulepin, doxepin, imipramine, lofepramine, nortriptyline and trimipramine)
  • The tricyclic-like antidepressant trazodone

The newer agents agomelatine (Valdoxan), mirtazapine (Zispin Soltab) and vortioxetine (Brintellix) are also included.

Use the table to check whether agents should be cross-tapered when switching or existing treatment withdrawn with a washout period before starting the next. You can also find advice on the recommended starting dose for the new agent.

For patients who are ready to stop antidepressant treatment, the table provides recommendations for prescribers on the timing of withdrawal.

Drug names link through to the full MIMS entries for more detailed prescribing information on each branded or generic product.

Recommendations are derived from the latest edition of The Maudsley Prescribing Guidelines in Psychiatry and from manufacturers' Summaries of Product Characteristics (SPCs).

Go to the MIMS switching antidepressants table

Want news like this straight to your inbox?
Sign up for our bulletins

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Already registered?
Sign in

Register or Subscribe to MIMS

GPs can get MIMS print & online and GPonline for free when they register online – take 2 minutes, and make sure you get your free MIMS access! If you're not a GP, you can subscribe to MIMS for full access.

Register or subscribe

MIMS Dermatology

Read the latest issue online exclusively on MIMS Learning.

Read MIMS Dermatology

MIMS Adviser

Especially created for prescribing influencers.

Request free copy

Mobile apps

MIMS: access the full drug database and quick-reference tables on the go

MIMS Diagnosis and Management: concise information on signs and symptoms, investigations and diseases