What is the Best Way to Change Antidepressant Medications?

Different approaches doctors use to switch antidepressant medications plus taking antidepressants during pregnancy - is it safe.

Gold Standard for Treating Depression (part 10)

According to Dr. John Preston, board certified neuropsychologist and co-author of several books on depression, healthcare professionals will use one of three approaches when switching from one antidepressant to another.

1. Stop the first drug and immediately start the second drug. The advantage to this method is a decreased chance that depression symptoms will return- as they might if a drug is stopped with no replacement. The problem is that there is a risk for drug interactions or increased side effects. FYI: Prozac is one drug that can suddenly be discontinued without severe withdrawal symptoms due to the fact that it stays in the body much longer than most antidepressants. It has its own built-in taper effect that is the equivalent of reducing the medications slowly. Thus, as compared to other antidepressants, it may be safer to quit Prozac and immediately try a new antidepressant.

2. Do a "washout" by taking a week or two with no medications at all. The advantages are that drug-drug interactions are less likely as the first drug is completely eliminated from the body before starting the next. The disadvantage is that there can be strong antidepressant withdrawal symptoms and or break-through depressive symptoms.

3. Reduce the dose of the first drug while starting on a low dose of the second drug: this is a conservative approach often used that may avoid the problems of the other two strategies. In any event, gradual dose reduction will almost always work to avoid withdrawal symptoms.

4. Augment the current drug. This involves a healthcare professional deciding what new drug will best work with a current medication.

Are Antidepressants Safe If I'm Pregnant?

Every antidepressant is different regarding safety before and after pregnancy. This is a topic that must be discussed thoroughly with a medical professional. You can also do your own research on the web to bring into a consultation with your healthcare professional.

The FDA ruled that Paxil can produce birth defects and warned other antidepressants should be used cautiously and judged by risk to mother vs. baby. Women with depression regularly have healthy babies. You will need to research your antidepressant medications carefully and speak with your doctor about your options.

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