How to Switch From an SNRI to an SSRI

Switching from a serotonin norepinephrine reuptake inhibitor to a selective serotonin reuptake inhibitor requires time and caution. Discontinuation of an serotonin norepinephrine reuptake inhibitor (SNRI) must occur gradually to avoid severe withdrawal symptoms. Individuals must also wait for the effects of an SNRI to wear off before starting an selective serotonin reuptake inhibitor (SSRI) due to the risk of serotonin syndrome. The Mayo Clinic warns serotonin syndrome is a potentially fatal condition resulting from toxic accumulations of serotonin in the body. Combining the effects of serotonin-active drugs heightens the risk of serious complications and may result in death.

Things You'll Need

• Physician

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Instructions

• 1

  Consult a physician. The National Institute of Mental Health advises individuals seek guidance from their physicians before stopping any antidepressant medication. Physicians will also determine which SSRI, if any, is best suited for individuals depending on medical history and mental health needs.

• 2

  Reduce SNRI dosage gradually according to physician recommendation. The Mayo Clinic cautions stopping an SNRI suddenly can lead to unpleasant complications including headache, diminished energy, and nausea.

• 3

  Consult a physician if withdrawal symptoms occur. The U.S. National Library of Medicine reports individuals may experience insomnia, mood change, seizure, and other symptoms when stopping an SNRI. It may be necessary to temporarily increase dosage to combat SNRI withdrawal. Some symptoms may be managed with additional medication.

• 4

  Wait for the half-life of the SNRI to expire. Half-life, the time required for a medication's effect to wear off once discontinued, varies by SNRI. A physician can provide information about the specific SNRI being discontinued and the waiting period necessary to safely begin SSRI therapy. Starting an SSRI too soon after discontinuing SNRI use may result in serotonin syndrome.

• 5

  Start taking the SSRI at the dose recommended by the prescribing physician. Dosage will likely begin low and increase over time to ensure patient safety and prevent undesired side effects. Watch for positive and negative effects and take notes to share with the physician.

• 6

  Consult with the prescribing physician regularly when starting a new antidepressant to discuss its benefits, complications, and possible dose changes. Share notes, questions, and concerns.

• 7

  Slowly increase or decrease SSRI dosage according to physician recommendation until achieving the desired effect. It may be necessary to cut back or discontinue an SSRI if side effects are intolerable.