Published: 1 September 2016

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Switching Antidepressants — Careful Management Required

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Prescriber Update 37(3): 35
September 2016

The Centre for Adverse Reactions Monitoring (CARM) recently received a report of a patient who experienced severe withdrawal symptoms within 72 hours of stopping paroxetine1. These symptoms, which included dizziness, vertigo, confusion, paraesthesia and excessive dreaming, affected their ability to drive and attend work. The patient had been advised to stop taking paroxetine five days prior to commencing a new antidepressant.

Healthcare professionals are reminded that careful management is required when switching antidepressants to reduce the risk of serotonin syndrome, hypertensive crisis or withdrawal syndrome2.

When managing a switch, refer to the New Zealand Formulary table on switching antidepressants (http://nzf.org.nz/nzf/resource/Antidepressant_Switching_Table.pdf). The table provides general guidance on how to safely and effectively switch between antidepressants2. Further information regarding switching antidepressants can be found in individual medicine data sheets, available on the Medsafe website (www.medsafe.govt.nz/Medicines/infoSearch.asp).

Please continue to report any adverse reactions to CARM. Reports can be submitted on paper or electronically (https://nzphvc.otago.ac.nz/).

References
  1. CARM case ID 119445. URL: www.medsafe.govt.nz/Projects/B1/adrsearch.asp.
  2. New Zealand Formulary. 2016. Antidepressant drugs. NZF v45. URL: www.nzf.org.nz/nzf_2225 (accessed 23 February 2016).
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