Switching Antidepressants: 5 Things You Should Know, Plus a Helpful Chart

Antidepressants are common medications. They’re used to treat many different mental health conditions, including major depression, anxiety, panic disorder, and more. 

A lot of people find that their symptoms get better about 1 month after starting an antidepressant. But what if your medication doesn’t work as well as you had hoped? Or you’re having a lot of side effects? In these cases, it could be time to talk with a healthcare professional about switching to another antidepressant. 

Starting a new antidepressant doesn’t have to be scary — but it’s helpful to know what to expect. Here are five things to keep in mind when switching to a new antidepressant, as well as a handy antidepressant switching chart. 

Antidepressant switching chart

Let’s be clear: Switching antidepressants isn’t a one-size-fits-all process. 

When switching you to a new antidepressant, a healthcare professional will consider:

• Your current symptoms

• Your current diagnosis

• Your current medication’s side effects

• How well you’re able to function in daily life

• How sensitive you are to the side effects of medication

• Whether you’re at risk for life-threatening complications

• Whether you have any other medical problems

• Your treatment goals

• Your preferences

Your prescriber will use all of this information — combined with their knowledge about medication effectiveness and safety — to decide how quickly to switch you over to a new antidepressant.

In general, there are four different strategies for switching antidepressants:

1. Direct switch: This means you stop your old antidepressant and start the new one the next day. 

2. Cross-taper: This means you gradually lower (taper) the dose of your old antidepressant, while slowly starting the new one at the same time. This usually happens over a 1- to 2-week period. 

3. Taper and switch: This means you taper and stop your old antidepressant, and then, once you’ve fully stopped your old antidepressant, you start the new one the next day. 

4. Taper and switch with a medication-free washout period: This means you taper and stop your old antidepressant, and then wait a period of time (days or weeks) before starting the new medication. This strategy is used when the two antidepressants have the potential to interact with each other. 

Below is an antidepressant switching chart with information about the process broken down. This will help you understand the different strategies your prescriber might use, depending on your medications.

You can refer to this antidepressant switching chart for more details.

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5 things you should know before switching antidepressants

1. Your new antidepressant might take a while to kick in

Antidepressants can take up to 1 month to start working in full effect. Until then, your symptoms may get better, worse, or stay the same. 

During this time, be sure to keep track of how you’re feeling. Tell your prescriber if anything worries you, and appreciate your progress — even if it’s slow. Above all, even if you feel like your antidepressant isn’t helping, don’t stop taking it before talking with your prescriber.

2. You may have side effects when starting your new medication

Like any medication, antidepressants can have side effects. And that’s true even if you’ve been on antidepressants before. 

Side effects are different for each medication. Common side effects for SSRIs and SNRIs include:

• Nausea and stomach pain

• Diarrhea and constipation

• Fatigue

• Problems sleeping

• Low libido

• Problems with orgasm

• Appetite changes

• Headaches

Other types of antidepressants can have different side effects. 

For most people, the side effects of antidepressants are temporary. They usually get better within a couple of weeks. 

But if side effects are bothering you, talk with a healthcare professional. They can help you understand whether your side effects are normal and whether you can expect them to go away. A healthcare professional may also be able to adjust your medication to help with side effects. 

3. You may experience withdrawal symptoms when switching antidepressants

If you’ve been on your current antidepressant for more than a few weeks, it’s possible that you’ll experience withdrawal symptoms when slowing down and/or stopping your medication. This is sometimes called antidepressant discontinuation syndrome. 

Different medications have different withdrawal symptoms. Physical symptoms can include:

• Flu-like symptoms

• Sleep changes

• Nausea or vomiting

• Dizziness or problems with balance

• Burning, tingling, or electric shock-like sensations

Tapering off your medication can also cause mood and anxiety symptoms, including:

• Mood changes

• Difficulty concentrating

• Irritability

• Anxiety

• Low mood

• Nightmares or vivid dreams

• Suicidal thoughts

These symptoms usually go away in 1 to 2 weeks, as your body adjusts to being off of the medication. In some cases, they’ll also get better when you start your new antidepressant. 

But, in the meantime, talk with a healthcare professional if withdrawal symptoms are bothering you. They can suggest strategies to help you feel more comfortable while transitioning to the new medication. 

4. Therapy can help you feel better when starting a new antidepressant

In addition to starting a new antidepressant, starting or continuing therapy can also help you get better. There’s evidence that therapy works well for many different mental health conditions, including:

• Major depression

• Anxiety

• Eating disorders

• Post-traumatic stress disorder (PTSD) 

According to the American Psychological Association, certain types of therapy work just as well — or sometimes even better — than medication. And in some cases, combining therapy with medication might actually give you the best result. 

5. Remember to take good care of yourself while switching to a new antidepressant

Switching to a new antidepressant can be hard. It’s important to make time for self-care while you’re adjusting to the new medication. Try to:

• Take it easy at work, school, and home.

• Get regular sleep.

• Add in physical activity.

• Enjoy nutritious foods.

• Be kind to yourself.

• Connect with a peer support group.

And remember: Communication is key. Be sure to reach out to a healthcare professional with any questions or concerns. They can help you understand what you’re going through and encourage you to keep moving forward. 

It can also be helpful to let your friends and family know that you’re transitioning to a new medication, so that they can support you in taking the next step.

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Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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