squirt asked
I'm switching from 20 mg of Lexapro to 50 mg of Zoloft. My doctor prescribed 10 mg of Lexapro and 50 mg of Zoloft for 4 weeks. Is this the correct way to taper from one drug to another?
Answer
The need to switch your antidepressant medication from the initial choice is common. In fact, up to two-thirds of individuals don't achieve appropriate effect from their first medication. Studies show that individuals can have a positive response to a medication in the same class (e.g. from one SSRI to another) or to a different class of medication all together.
There are many possible effective options for switching from one SSRI (selective serotonin re-uptake inhibitor) to another and there is no single recommended way that has proven superior to others. There is evidence to suggest that simply switching from one SSRI to another, with no dosage adjustment, is well tolerated.
However, tapering may be the more effective option for certain individuals if there is a concern with an increased risk of symptom recurrence or discontinuation (i.e. withdrawal) symptoms.
Switching From Lexapro To Zoloft
As mentioned above, there is no single method of switching that is preferred over another. The approach taken is typically patient specific and should be based on a discussion with your doctor. Whatever method is used, it is important to be monitored and adjust your strategy based on how you are tolerating your new therapy.
Three of the more common strategies employed to switch between SSRI medications (such as Lexapro and Zoloft) based on studies are as follows:
- Stop your current SSRI (e.g. Lexapro). Start the SSRI (e.g. Zoloft) at a low dose and increase slowly to an effective dose.
- Decrease your current SSRI (e.g. Lexapro) dose while initiating the new SSRI (e.g. Zoloft) at a low dose. Slowly decrease the prior agent while slowly increasing the new agent to your target dose.
- Stop your current SSRI (e.g. Lexapro) and start the new SSRI (e.g. Zoloft) at your new target dose. This method may increase risk of serotonergic side effects.
It is important to remember that there is no one size fits all approach. Be sure to keep in contact with your doctor to discuss how your switch is going and whether or not you are experiencing any side effects.
