Antidepressant switching
Our advice on antidepressant switching guides on establishing whether a switch is necessary, choosing an antidepressant to switch to, agreeing a strategy, and monitoring. We also give advice on suitable strategies for a range of potential switches.
Establishing if a person needs to switch their antidepressant
17 February 2023Prior response, side-effects, new contraindications, and current depression symptoms may require switching antidepressants. When it is, establish shared goals.
Considerations when choosing an alternative antidepressant
17 February 2023Consider the risks associated with switching an antidepressant for depression, the patient's individual circumstances and when to seek specialist advice.
Planning and agreeing an antidepressant switching strategy
17 February 2023Guidance on planning and implementing the antidepressant switch after the need and choice of antidepressant have been decided.
Monitoring a person during and after antidepressant switching
17 February 2023Review people at appropriate time points; advise on what to expect and report; and beware of the possibility of withdrawal symptoms and serotonin syndrome.
Agomelatine to other antidepressants: switching in adults
17 September 2024Suggested methods for switching safely from agomelatine to other antidepressants. Switches requiring additional specialist support are highlighted.
Tricyclics to other antidepressants: switching in adults
31 May 2024Suggested methods for switching safely between tricyclics or to other antidepressants. Switches requiring additional specialist support are highlighted.
SNRIs to other antidepressants: switching in adults
31 May 2024Suggested methods for switching safely between SNRIs or to other antidepressants. Switches requiring additional specialist support are highlighted.
Moclobemide to other antidepressants: switching in adults
31 May 2024Suggested methods for switching safely from moclobemide to other antidepressants. Switches requiring additional specialist support are highlighted.
Mirtazapine to other antidepressants: switching in adults
31 May 2024Suggested methods for switching safely from mirtazapine to other antidepressants. Switches requiring additional specialist support are highlighted.
Trazodone to other antidepressants: switching in adults
31 May 2024Suggested methods for switching safely from trazodone to other antidepressants. Switches requiring additional specialist support are highlighted.
MAOI to other antidepressants: switching in adults
31 May 2024Switching between or from a monoamine oxidase inhibitor (MAOI) is a complex switch and requires support from a specialist. General principles are described.
Vortioxetine to other antidepressants: switching in adults
31 May 2024Suggested methods for switching safely from vortioxetine to other antidepressants. Switches requiring additional specialist support are highlighted.
SSRIs to other antidepressants: switching in adults
31 May 2024Suggested methods for switching safely between SSRIs or to other antidepressants. Switches requiring additional specialist support are highlighted.
Switching strategies for antidepressants
22 May 2024The choice of antidepressant switching strategy depends on the person and antidepressant. We describe the current strategies and their application.
Other medicines switches
Example medicines to prescribe by brand name in primary care
15 January 2026Prescribe certain medicines by brand to ensure supply of the same product. Examples are grouped by therapeutic area. The list of products is not exhaustive.
Switching between gabapentin and pregabalin for neuropathic pain
14 January 2026An overview of possible dose equivalences, switching methods and considerations to make before switching between immediate-release gabapentinoids.
Switching between pyridostigmine and neostigmine
23 December 2025Switching between pyridostigmine and neostigmine in myasthenia gravis requires care and application of a stepped process.
Using mesalazine tablets appropriately
19 December 2025An overview of differences between mesalazine tablet preparations and clinical considerations when switching between preparations.
Switching between aminophylline and theophylline in adults
4 July 2025Intravenous (IV) aminophylline is used in emergency respiratory conditions. We provide guidance on switching between oral theophylline and IV aminophylline.
Switching between morphine and other opioids in palliative care
1 April 2025Switching between oral morphine and other oral opioids requires care and thoughtful application of a stepped process.
An example oral opioid switch from morphine to oxycodone
1 April 2025An example scenario to support you when switching or advising on switching between morphine and other oral opioids in cancer and palliative care.
Estimating dose equivalence from oral morphine to other opioids
1 April 2025Use our tool to obtain approximate dose equivalences of oral morphine to other oral opioids and help you calculate an estimated equivalent daily dose.
Considerations when switching between solid doses and liquids
3 April 2024Bioavailability, release profile and licensed uses are some of the considerations needed when changing between solid dose and liquid formulations.
Switching between oral prednisolone and IV hydrocortisone
19 December 2023Switching between oral prednisolone and intravenous (IV) hydrocortisone requires care due to the risk of adrenal insufficiency or adrenal crisis.