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Common side effects of antidepressant switching or discontinuation include: Returning symptoms of depression. Suicidal thoughts. Serotonin syndrome. Irritability. Flu-like symptoms. Dizziness.
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Among the patients who were switched to a different antidepressant, there was no significant difference among the different antidepressants. For level three, the remission rates based on the HAM-D symptom scale were 12.3% for mirtazapine and 19.8% for nortriptyline, although the difference was not large enough for statistical significance. [5]
In adults and children with bipolar disorder, SSRIs may cause a bipolar switch from depression into hypomania/mania, mixed states or rapid cycling. [159] When taken with mood stabilizers , the risk of switching is not increased, however when taking SSRIs as a monotherapy , the risk of switching may be twice or three times that of the average.
The American Psychiatric Association 2000 Practice Guideline advises that where no response is achieved within the following six to eight weeks of treatment with an antidepressant, switch to an antidepressant in the same class, and then to a different class. A 2006 meta-analysis review found wide variation in the findings of prior studies: for ...
There is support for the effectiveness of switching people to a different SSRI; 50% of people that were non-responsive after taking one SSRI were responsive after taking a second type. Switching people with treatment-resistant depression to a different class of antidepressants may also be effective.
Sertraline, sold under the brand name Zoloft among others, is an antidepressant medication of the selective serotonin reuptake inhibitor (SSRI) class [10] used to treat major depressive disorder, generalized anxiety disorder, social anxiety disorder, obsessive–compulsive disorder (OCD), panic disorder, and premenstrual dysphoric disorder. [11]
This translates to the 2nd- and 3rd-most-common antidepressants, behind Lexapro (escitalopram), an SSRI. [88] In some studies, SNRIs demonstrated slightly higher antidepressant efficacy than the SSRIs (response rates 63.6% versus 59.3%). [43] However, in one study escitalopram had a superior efficacy profile to venlafaxine. [89]