The effectiveness of switching antidepressants during remission: a case series of depressed patients who experienced intolerable side effects.
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.
Posternak
Michael A
MA
Bayside Medical Center, 235 Plain St., Suite 501, Providence, RI 02905, USA. mposternak@lifespan.org
Zimmerman
Mark
M
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
D000928:Antidepressive Agents