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We would like to express our condolences to those mourning the loss of psychiatrist Dr. Ronald Onkin of Encino, CA.

Antidepressant Switching Guide

Antidepressant Switching Guide

Evidence-based recommendations from major clinical guidelines

Switching FROM Select current medication… Fluoxetine (Prozac) Sertraline (Zoloft) Paroxetine (Paxil) Citalopram (Celexa) Escitalopram (Lexapro) Fluvoxamine (Luvox) Venlafaxine (Effexor) Desvenlafaxine (Pristiq) Duloxetine (Cymbalta) Levomilnacipran (Fetzima) Bupropion (Wellbutrin) Mirtazapine (Remeron) Vortioxetine (Trintellix) Vilazodone (Viibryd) Trazodone (Desyrel) Agomelatine (Valdoxan) Amitriptyline (Elavil) Nortriptyline (Pamelor) Imipramine (Tofranil) Clomipramine (Anafranil) Doxepin (Sinequan) Phenelzine (Nardil) Tranylcypromine (Parnate) Selegiline (Emsam) Moclobemide (Manerix)

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Switching TO Select new medication… Fluoxetine (Prozac) Sertraline (Zoloft) Paroxetine (Paxil) Citalopram (Celexa) Escitalopram (Lexapro) Fluvoxamine (Luvox) Venlafaxine (Effexor) Desvenlafaxine (Pristiq) Duloxetine (Cymbalta) Levomilnacipran (Fetzima) Bupropion (Wellbutrin) Mirtazapine (Remeron) Vortioxetine (Trintellix) Vilazodone (Viibryd) Trazodone (Desyrel) Agomelatine (Valdoxan) Amitriptyline (Elavil) Nortriptyline (Pamelor) Imipramine (Tofranil) Clomipramine (Anafranil) Doxepin (Sinequan) Phenelzine (Nardil) Tranylcypromine (Parnate) Selegiline (Emsam) Moclobemide (Manerix)

Patient Factors

On current medication >1 year Sensitive to medication changes History of discontinuation symptoms Severe depression / high relapse risk

Recommended Switching Strategy

Select medications above to see switching recommendations

Disclaimer: This tool provides general guidance based on published clinical guidelines. Individual patient factors may require modification of these recommendations. Always use clinical judgment and consult relevant prescribing information. This tool is not a substitute for professional medical advice.