Guide to Switching Antipsychotics

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Overview: Antipsychotics have helped many people control the symptoms of their mental health conditions. However each antipsychotic is different – with some proving to be more effective for some people compared to others. Finding the right antipsychotic can take time. In this article, we provide general guidance on how to switch antipsychotics. While there are no published controlled trials on switching antipsychotics, we are able to come up with some general principles for switching.

 

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Notices: We have a profile on all of the medicines listed on this page. For added information on any of these medicines, you are advised to locate the medicine on this page and view the profile.

 

Choosing the First Antipsychotic: General medical practice dictates that the choice of the first antipsychotic should be made between both the patient and the clinician. This involves choosing an antipsychotic that fits the symptoms shown, as well as the medical history of the patient. Generally, atypical antipsychotics are preferred to begin with as opposed to typical antipsychotics. Clozapine is normally prescribed once other antipsychotics haven’t worked.

 

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When First Switching: It is recommended to avoid an abrupt withdrawal of one antipsychotic to another. This could cause withdrawal effects from one antipsychotic – and would be coupled with side effects from a new antipsychotic. Instead, it is recommended to slowly lower the dosage of the ineffective antipsychotic, before introducing the new antipsychotic at a lower dose – before slowly titrating the dose upwards.

 

Table: The following table summarises the five strategies of switching antipsychotics. However, it is important to ask a qualified mental health professional or General Practitioner regarding switching antipsychotics.

 

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Cautions

ALWAYS EXERT CAUTION WHEN SWITCHING ANTIPSYCHOTICS.

EXERT CAUTION WHEN REDUCING DOSAGES, AND DO SO GRADUALLY

ASK YOUR DOCTOR FOR ADVICE

 

Specific Cautions: Now, we provide some of the specific antipsychotic changes that have in the past resulted in problems. Therefore, particular caution should be taken when making any of the following switches. As always, ask your doctor for advice.

 

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Cautions

ALWAYS EXERT CAUTION WHEN SWITCHING ANTIPSYCHOTICS.

EXERT CAUTION WHEN REDUCING DOSAGES, AND DO SO GRADUALLY

ASK YOUR DOCTOR FOR ADVICE

 

Notes: It can be very difficult for clinicians to find the equivalent dose when switching antipsychotics. Antipsychotics all have a different potency level, making it difficult to switch. Furthermore, the half-life of each antipsychotic will need to be considered. Therefore, a low dose is likely to be prescribed at the start of the switch.

 

Disclaimer: The information above is merely supposed to act as a guide, and doesn’t replace the opinion of a mental health professional or General Practioner. Always seek their advice, and exert caution when switching from one antidepressant to another. While extensive time and research has been undertaken to complete this article, mistakes are possible. We accept no responsibility for any harm or damage caused by the information in this page. To reiterate, this page is merely a guide, and you should always consult your Doctor over switching antidepressants.

 

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