[Switching and stopping antidepressants]

Encephale. 2018 Sep;44(4):379-386. doi: 10.1016/j.encep.2018.08.001. Epub 2018 Aug 31.
[Article in French]

Abstract

Major depressive disorder (MDD) is a common, typically recurrent, sometimes chronic and very disabling disorder, with a lifetime prevalence of 20%. Moreover, antidepressant treatments may be partially effective. Studies have found that up to 60% of patients with MDD do not fully respond to the first antidepressant prescribed. Thus, switching antidepressants is a common strategy for antidepressant non-responders. When switching between antidepressants, an appropriate switching strategy should be used, depending on the characteristics of the first and the second antidepressant and patient's background. Patients should be informed that antidepressants can cause discontinuation symptoms if stopped abruptly after prolonged used. Relapse and exacerbation of depression can also occur during a switch. Thus, all antidepressant switches must be carried out cautiously and under close observation. This article summarizes the recommendations for an optimal antidepressant switch.

Keywords: Antidepressants; Antidépresseurs; Depression; Dépression; Switch.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / therapeutic use*
  • Depression / drug therapy*
  • Depression / epidemiology
  • Drug Substitution* / statistics & numerical data
  • Humans
  • Recurrence
  • Withholding Treatment* / statistics & numerical data

Substances

  • Antidepressive Agents