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Considerations when etablishing whether a person needs to switch their antidepressant

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Considerations when establishing whether a person needs to switch their antidepressant

  • a clinician should adopt a shared approach from the beginning in establishing whether a person might benefit from switching their antidepressant
  • discuss existing issues and experiences, and how medicines fit in with a typical day

Points to consider include the following:

  • Inadequate response
    • discuss with the person and/or their carer whether their current antidepressant is effective after they have adhered to a therapeutic dose, for an appropriate duration
  • Side-effects
    • discuss with the person and/or their carer any side-effects they have experienced (such as weight gain or reduced libido). Abrupt withdrawal should be avoided unless the person experiences a serious side-effect
  • New contraindications and interactions
    • people may develop a new contraindication to their existing antidepressant or they may start a new medication that interacts with their existing antidepressant. Establish whether this is the case
  • Current symptoms
  • Agree goals
    • use a shared decision making approach to agree the purpose of the switch with your patient and what will be achieved from it.
  • Share decisions
    • discuss with the person and/or their carer the purpose of the switch and what you’re trying to achieve. Consider:
    • what matters to them
    • any concerns they have
    • the extent of the side-effects they could tolerate
    • whether a trial period without an antidepressant might be useful

Reference:


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