title: The effectiveness of switching antidepressants during remission: a case series of depressed patients who experienced intolerable side effects.
abstract: BACKGROUND
  It is unknown whether depressed patients who have experienced intolerable side effects to one antidepressant can safely and effectively be switched to a second antidepressant while the depressive disorder is in remission. The present study sought to determine the viability of such a strategy.
  
  
  METHODS
  All subjects were psychiatric outpatients who were treated in an open-label manner according to standard clinical practice. From an initial cohort of approximately 200 patients with major depressive disorder, 9 had their antidepressant switched while in remission because of intolerable side effects. Their subsequent course was prospectively assessed at each follow-up visit using Standardized Clinical Outcome Ratings and the Clinical Global Impression-Improvement scale.
  
  
  RESULTS
  Patients were prospectively followed for 8 to 110 weeks (median, 30 weeks) subsequent to the initiation of the second antidepressant trial. Switching antidepressants effectively eliminated the problematic side effects in all 9 cases. No relapses occurred during the second antidepressant trial.
  
  
  CONCLUSIONS
  The present study provides preliminary evidence that switching antidepressants while in remission may be a safe and effective strategy for managing antidepressant-induced side effects.
  
  
  CONCLUSIONS
  Our findings are limited by the small sample size, lack of control group, and short follow-up periods in some cases.
authors.affiliation: Bayside Medical Center, 235 Plain St., Suite 501, Providence, RI 02905, USA. mposternak@lifespan.org
authors.forename: Michael A
authors.initials: MA
authors.lastname: Posternak
authors.forename: Mark
authors.initials: M
authors.lastname: Zimmerman
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000928:Antidepressive Agents