Changing antidepressants

We talked to people who had taken a number of different antidepressants over the years, or had tried one or two before finding one that suited them.

How people respond to an antidepressant can vary, so what works for one person may not work as well for another. Some people find that they experience side effects that are too unpleasant to tolerate, or they don’t feel any positive benefit from one antidepressant, but another might work better. It can sometimes take several tries to find one that works best for any particular individual.

Usually when people are prescribed an antidepressant for the first time they are advised to wait a few weeks before considering a change because it can take a few weeks for the benefits to become noticeable, and side effects should wear off after a short time.

Emma’s doctor told her to “Try it for a few weeks and come back – if you’re not feeling any better we’ll change it. It wasn’t just a case of ‘its not working, we’ll change it.'”

When Stuart was prescribed an antidepressant for the first time he was told by his GP, “This might not work for you, we might need to keep trying different ones until we find something.”

Not everyone realised that it was possible to change to a different antidepressant if the one they were prescribed didn’t suit them. Some said they would have liked more information about the options.

Several people described having started on one antidepressant, but after a time changing over to another one that might work more effectively, give fewer side effects, or have a particular desired effect, for example helping with specific symptoms such as anxiety or insomnia.

Stuart changed from venlafaxine to citalopram because of the effect venlafaxine had on his libido. Collette’s doctor changed her from fluoxetine to venlafaxine: “I’d just stopped taking fluoxetine, we just decided to try another one instead. It was just what the GP thought might be better, she obviously looked it up and was like ‘well I think we’ll give this one a try. I’ve heard some good reports about it.'”

Some stopped taking an antidepressant because they had felt better, but their symptoms had returned after a while. When that happened some said their doctor had changed them to a different antidepressant. The effectiveness of the antidepressant may change over time, so the doctor may change the dose, or prescribe a different one.

Some had specifically asked to try a different one if they had looked up information on the internet or heard about a particular antidepressant from a friend or relative.

People who changed GP sometimes had a medicines review and were changed to a different antidepressant.

Some thought different antidepressants were “in vogue” at different times or that doctors had their favourites, but they usually knew why their prescription had been changed.

Stuart changed antidepressants several times to find one that suited him

Age at interview 52

Gender Male

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Emma started on fluoxetine, but had difficulty sleeping…

Age at interview 30

Gender Female

Age at diagnosis 20

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Charlotte tried Cipramil (citalopram) and fluoxetine but they…

Age at interview 34

Gender Female

Age at diagnosis 20

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Some people had been advised to gradually stop taking one antidepressant before starting on a new one, but others said their doctors had changed them to a new one straight away. It depends on the particular antidepressant and how long it stays in the body after you stop taking it. Sharon had tried a number of different antidepressants over time and was puzzled about the fact that different doctors had given different advice on changing from one to another.

Tapering the dose is sometimes necessary when switching medicines. When people change to a new antidepressant they may experience discontinuation effects from stopping an antidepressant, or side effects from starting a new one. (See Stopping taking antidepressants).

Sharon felt puzzled that different doctors would switch them…

Age at interview 37

Gender Female

Age at diagnosis 22

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Catherine has been on several types of antidepressant over…

Age at interview 41

Gender Female

Age at diagnosis 14

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Sonia points out that each time the dose or medicine is…

Age at interview 31

Gender Female

Age at diagnosis 17

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We spoke to some people who had severe or recurrent episodes of depression and were extremely unwell. Over the course of time doctors had changed their antidepressants many times in an attempt to find something that would help. After so many changes it was difficult to remember which antidepressants they had taken, or when. A few people said that despite many changes they had not found one that helped.

Dina’s antidepressants had been changed several times…

Age at interview 46

Gender Female

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(See also Managing antidepressants, Stopping taking antidepressants, Being prescribed an antidepressant and Coping with antidepressant side effects).

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