Patients who are treated with antidepressants often will try several different ones in an attempt to find the one that works best for them. Troublesome side effects also can lead people to seek a change of medication. Antidepressant treatment can never be done on your own. If you want to change antidepressants, you must see your physician.
Step 1
Make an appointment with your psychiatrist. Arrange for a long appointment, of roughly one hour, and make sure you have follow-up appointments in the near future. You'll need to discuss not only the effects of your current medication, but also go over your history of treatment. In addition, it's important to talk about everything that's going on in your life--antidepressants can never be given in a vacuum. Switching to a different medication without addressing a major new stressor in your life will prove futile. Decide together on a course of treatment.
Step 2
Switch without tapering if you're changing within the same class of antidepressants, such as from one SSRI to another. You can usually stop using the medication one day and start the next day on a comparable dose of a different SSRI. For example, if you've been taking paroxetine at a dose of 20mg, you can simply start the next day taking citalopram at a dose of 20mg. This is not set in stone: Some medications in the same class are longer acting and you should wait a few days to let them clear from your system before starting a new one to avoid unintentionally doubling up on your dose.
Step 3
Taper your antidepressant. If you're taking a tricyclic antidepressant such as amitriptyline, which blocks receptors for acetylcholine, stopping it all at once can lead to a sudden excess of cholinergic effects, with symptoms such as nausea, vomiting, sweating and insomnia. Decrease your antidepressant gradually per your doctor's instructions. Sometimes you can start a low dose of the new antidepressant and increase it as you decrease the first--this is known as cross taper.
Step 4
Wait. Some medications require a wash-out period. MAO inhibitors are a class of antidepressants that should not be combined with any other antidepressant. If you've been on a MAO inhibitor, it can be very dangerous to start another medication before the effects of the first antidepressant have completely left your system. The same is true when stopping a different antidepressant and starting an MAOI--a wash-out period is required.
Tips and Warnings
- Work together with your doctor. Educate yourself about your medication
- Never combine antidepressants unless instructed to do so by your doctor.
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