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How Do You Switch From One SSRI To Another SSRI?


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#1 Evey

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Posted 03 March 2012 - 03:21 PM

Hi everyone,

I was wondering what the process is when you switch from one SSRI to another SSRI. Do you just stop the one you've been taking and start the other or do you taper down as you start the other or... ?

I'm most interested in changing from 40 mg of Paxil to Zoloft, but interested in hearing anyones story.

Thanks! :)
DX: Panic Disorder, MDD, PTSD, Nightmares, Social Anxiety, PD NOS. Possibly Bipolar 2

RX: Latuda 20 mg, Paxil 20 mg, Klonopin 1 mg TID, Prazosin 1 mg, Propranolol 20 mg as needed

Failed RX: Lexapro, Zyprexa, Remeron, Abilify, Risperdal, Seroquel XR, Buspar, Xanax, Trazodone, Wellbutrin, Pamelor, Effexor, Lunesta, Ambien, Zoloft, Celexa, Cogentin


#2 tryp

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Posted 03 March 2012 - 03:26 PM

When I switched from Celexa to Zoloft, I tapered down the Celexa and started the Zoloft two weeks later, but I think there were other factors involved. IIRC my pdoc wanted to see how I would feel off Celexa before adding another drug.

You can do it a couple of different ways - whatever your doc recommends is probably fine. I have also done cross-tapers between antidepressants before, where you decrease the dose of one at the same time as increasing the dose of the other.

Dx: Complex PTSD
Tx: Lamictal (250) + prazosin (7.5) + "therapy"


#3 Calypte

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Posted 03 March 2012 - 03:31 PM

I think it just depends on your doctor. I just quit Lexapro (20 mg) cold-turkey when I switched to Zoloft (50 mg) and didn't have any problems. Same thing when I went from Zoloft to Effexor (an SSRI, technically). However, Paxil is the SSRI that tends to have the worst withdrawal symptoms, so there's something to be said for doing a cross-taper.

Dx: recurrent atypical MDD, autism spectrum, avoidant & borderline traits
Rx: Wellbutrin XL 300 mg
Previous Rx: Effexor XR/IR, Celexa, Lexapro, Zoloft, lithium, Abilify, oxazepam


#4 Eden

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Posted 03 March 2012 - 03:35 PM

In my only experience between SSRIs I titrated down on one while simultaneously titrating up on another.

I'd say it didn't go well but SSRIs jsut don't agree with me, regardless of the apporach.

Edited by Eden, 03 March 2012 - 03:36 PM.

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#5 hallowedink

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Posted 03 March 2012 - 03:58 PM

I stopped Citalopram c/t, but I tapered off Fluoxitine. Depends on your doctor and your dosasge, etc.

My Brain Salad: BPD, MDD, Insomnia, Anorexia Nervosa, "very likely" C-PTSD, Migraines
What they give me for it: Seroquel 300mg, Wellbutrin 300mg, Lofepramine 140mg, Pizotifen 3mg, Naproxen PRN, Zopiclone PRN, Valium PRN`

Have also dealt with: Panic Disorder (now in remission), Self-harm (stopped ~4 months, but still relapsing occasionally)


#6 rowan77

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Posted 03 March 2012 - 04:14 PM

when i went off seroxat/paxil I was in hospital and I tapered off over a week and then went on zispin/remeron. I had no problems coming off paxil, however I do know that a lot of people have problems withdrawing from it

DX: Bipolar Disorder, Social Anxiety Disorder

Current RX: Lithium Carbonate 800mg, Seroquel XR 800mg, Lamictal 100mg x2 daily, Procyclidine 5mg, prozac 40mg, Zopiclone 7.5mg PRN 

Also Yasmin 0.3/3mg for PCOS and Losec 40mg for Hiatus Hernia, Oesophagitis and Gastritis

 

Previous RX:
Anti-depressants: dothiepin, clomipramine, paroxetine, mirtazepine, lofepramine, venlafaxine, escitalopram, agomelatine
Anti-psychotics: thoridazine, risperidone, olanzapine, haloperidol, aripiprazole, chlorpromazine
Mood Stabilisers: carbamazepine, sodium valproate,
Anxiolytics: alprazolam, diazepam, lorazepam, clonazepam
Hypnotics: lormetazepam, temazepam, zolpidem, flurazepam
ECT: 6 Treatments in 2003; 11 Treatments in 2005

"Be yourself - everybody else is taken." Oscar Wilde


#7 The Emperor

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Posted 03 March 2012 - 04:26 PM

I don't know. Some people's doctors have them taper off the current AD and then go on to the next one. I know that my doctor would just switch me from AD to AD without tapering anything. Maybe I'd take a day break between taking the old one and taking the new one sometimes. Don't know why that was. But yeah, in my experience, you just go from one to the next, and for me there were no ill effects. But YMMV.

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#8 jt07

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Posted 03 March 2012 - 04:56 PM

If going from SSRI to SSRI, I usually just stop taking on and start the other. I don't get discontinuation symptoms as long as I start the new SSRI right away. I only have a problem coming completely off SSRI's.

Dx: Atypical MDD with anxiety, possible ADD, OCD (mostly recovered)
Rx: Citalopram (20 mg), Remeron (45 mg), Abilify (30 mg), Carbamazepine (800 mg), Lamotrigine (200 mg), Ritalin (20 mg AM, 10 mg PM)


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#9 San

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Posted 03 March 2012 - 05:48 PM

In my personal experience, I've just switched AD's (except for MAOI's) from one to the other, no tapering. That's just experience. I had no problems.

Dx: Schizoaffective disorder - bipolar type, ADHD - Inattentive

Rx: Piportil Depot (75mg injection, 2 weeks) Clonazepam (2mg) Ritalin(30mg) Gabapentin (300mg and going up) Wellbutrin (150mg) Artane (10mg) Seroquel (100mg) ECT (2008)

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#10 Evey

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Posted 03 March 2012 - 06:34 PM

Has anyone switched from Paxil to Zoloft. I wonder what the equalivant dose is for 40 mg of Paxil. I'm a bit worried about changing. I've been on Paxil for almost 10 years at various dosages, but I feel like it isn't working as well as it once did. :/
DX: Panic Disorder, MDD, PTSD, Nightmares, Social Anxiety, PD NOS. Possibly Bipolar 2

RX: Latuda 20 mg, Paxil 20 mg, Klonopin 1 mg TID, Prazosin 1 mg, Propranolol 20 mg as needed

Failed RX: Lexapro, Zyprexa, Remeron, Abilify, Risperdal, Seroquel XR, Buspar, Xanax, Trazodone, Wellbutrin, Pamelor, Effexor, Lunesta, Ambien, Zoloft, Celexa, Cogentin

#11 tryp

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Posted 03 March 2012 - 06:47 PM

As far as I know, 40 mg of Paxil is equal to about 100 mg of Zoloft.

Dx: Complex PTSD
Tx: Lamictal (250) + prazosin (7.5) + "therapy"


#12 Evey

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Posted 04 March 2012 - 12:23 AM

Theres probably a conversion chart on the net somewhere. I'll look.
DX: Panic Disorder, MDD, PTSD, Nightmares, Social Anxiety, PD NOS. Possibly Bipolar 2

RX: Latuda 20 mg, Paxil 20 mg, Klonopin 1 mg TID, Prazosin 1 mg, Propranolol 20 mg as needed

Failed RX: Lexapro, Zyprexa, Remeron, Abilify, Risperdal, Seroquel XR, Buspar, Xanax, Trazodone, Wellbutrin, Pamelor, Effexor, Lunesta, Ambien, Zoloft, Celexa, Cogentin

#13 Evey

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Posted 04 March 2012 - 12:49 AM

Anyone have a link to one?
DX: Panic Disorder, MDD, PTSD, Nightmares, Social Anxiety, PD NOS. Possibly Bipolar 2

RX: Latuda 20 mg, Paxil 20 mg, Klonopin 1 mg TID, Prazosin 1 mg, Propranolol 20 mg as needed

Failed RX: Lexapro, Zyprexa, Remeron, Abilify, Risperdal, Seroquel XR, Buspar, Xanax, Trazodone, Wellbutrin, Pamelor, Effexor, Lunesta, Ambien, Zoloft, Celexa, Cogentin

#14 Velvet Elvis

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Posted 04 March 2012 - 03:47 AM

I think 40mgs Paxil = 200mgs zoloft. Both are the max recommended effective dose for depression for each drug.

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#15 rowan77

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Posted 04 March 2012 - 08:31 AM

Approximate equivalent dosages of SSRIs:
citalopram 20mg
escitalopram 5 mg
fluoxetine 20mg
paroxetine 20mg
sertraline 50mg

http://www.globalrph...depressants.htm

DX: Bipolar Disorder, Social Anxiety Disorder

Current RX: Lithium Carbonate 800mg, Seroquel XR 800mg, Lamictal 100mg x2 daily, Procyclidine 5mg, prozac 40mg, Zopiclone 7.5mg PRN 

Also Yasmin 0.3/3mg for PCOS and Losec 40mg for Hiatus Hernia, Oesophagitis and Gastritis

 

Previous RX:
Anti-depressants: dothiepin, clomipramine, paroxetine, mirtazepine, lofepramine, venlafaxine, escitalopram, agomelatine
Anti-psychotics: thoridazine, risperidone, olanzapine, haloperidol, aripiprazole, chlorpromazine
Mood Stabilisers: carbamazepine, sodium valproate,
Anxiolytics: alprazolam, diazepam, lorazepam, clonazepam
Hypnotics: lormetazepam, temazepam, zolpidem, flurazepam
ECT: 6 Treatments in 2003; 11 Treatments in 2005

"Be yourself - everybody else is taken." Oscar Wilde


#16 heybeesly

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Posted 08 March 2012 - 10:37 AM

I'm switching from Celexa to Zoloft starting today, and my pdoc made me a whole week-by-week chart to get me through it.

This week I take 20mg Celexa in the morning, and 25mg Zoloft in the evening.

Next week I take 10mg Celexa in the morning, and 50mg Zoloft in the evening.

The third week I stop the Celexa and take 75mg Zoloft.

In the past I've always just stopped taking one and started the other without much issue. I'm interested to see how this cross-tapering works out.

#17 Evey

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Posted 08 March 2012 - 05:57 PM

I'm switching from Celexa to Zoloft starting today, and my pdoc made me a whole week-by-week chart to get me through it.

This week I take 20mg Celexa in the morning, and 25mg Zoloft in the evening.

Next week I take 10mg Celexa in the morning, and 50mg Zoloft in the evening.

The third week I stop the Celexa and take 75mg Zoloft.

In the past I've always just stopped taking one and started the other without much issue. I'm interested to see how this cross-tapering works out.


May I ask what you are taking the Zoloft for? I may be switching from Paxil to Zoloft
DX: Panic Disorder, MDD, PTSD, Nightmares, Social Anxiety, PD NOS. Possibly Bipolar 2

RX: Latuda 20 mg, Paxil 20 mg, Klonopin 1 mg TID, Prazosin 1 mg, Propranolol 20 mg as needed

Failed RX: Lexapro, Zyprexa, Remeron, Abilify, Risperdal, Seroquel XR, Buspar, Xanax, Trazodone, Wellbutrin, Pamelor, Effexor, Lunesta, Ambien, Zoloft, Celexa, Cogentin

#18 heybeesly

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Posted 09 March 2012 - 12:09 PM

May I ask what you are taking the Zoloft for? I may be switching from Paxil to Zoloft


For depression. I was on Celexa for a while, but it hasn't been helping very much and it seriously messes with my sleep. So, time to try something new. My pdoc said it might help with my anxiety a bit as well.

#19 Evey

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Posted 26 April 2012 - 10:46 AM

Hi everyone, I'm the person who started this thread. My doctor has me going down on Paxil while going up Zoloft. I was originally on 40 mg of Paxil. Right now I'm at 10 mg Paxil and 150 mg Zoloft. I am sooo very anxious, horribly. :( Do you know think its because of the Paxil withdrawal? And Zoloft hasn't kicked in yet? Please help.
DX: Panic Disorder, MDD, PTSD, Nightmares, Social Anxiety, PD NOS. Possibly Bipolar 2

RX: Latuda 20 mg, Paxil 20 mg, Klonopin 1 mg TID, Prazosin 1 mg, Propranolol 20 mg as needed

Failed RX: Lexapro, Zyprexa, Remeron, Abilify, Risperdal, Seroquel XR, Buspar, Xanax, Trazodone, Wellbutrin, Pamelor, Effexor, Lunesta, Ambien, Zoloft, Celexa, Cogentin

#20 crtclms

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Posted 26 April 2012 - 12:45 PM

My husband was crazy anxious when he came off of Paxil, plus he lost his temper easily. He doesn't even like to talk about it.

This was just when I met him, so I wasn't present for much of it, except the anxiety.

He is on Lexapro now, and hasn't noticed side effects. But there was a several year gap between the paxil and the Lexapro.

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Rx: Alprazolam; Botox; Buproprion; Dihydroergotomine via IV Infusion; Fish Oil; Flexeril; Lamotrigine; Latuda; Lithium; Metoclopramide; Midrin; Migranal; Potassium Citrate; Prilosec; Promethazine; Riboflavin; Tizanidine; Verapamil; Vitamin D3
Currently Shelved: Abilify; Amerge; Anaprox; Atenolol; Buspar; Cafergot; Cymbalta; Depakote; Di-Hydro-ergotamine, injected; Gabapentin; Geodon; Imitrex Tablets; Klonopin; Maxalt; Namenda; Nortriptyline; Norvasc; Propranolol; Prozac; Risperidone; Relpax; Sansert; Sumatriptan injectables; Tegretol; Trazadone; Zoloft; Zolpidem; Zomig; Zonegran


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