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What does cross tapering in antidepressants mean?


Official Answer Medically reviewed by N. France, BPharm. Last updated on Aug 30, 2021.

Cross-tapering is one strategy used to switch from one antidepressant drug to another.

How to cross taper antidepressants

When switching from one antidepressant to another the process should be closely monitored by your doctor.

A cross-taper switch involves:

  • Gradually reducing and then stopping the antidepressant you are currently on.
  • Starting you on a low-dose of the new antidepressant while the dose of the current antidepressant is being reduced, so that both antidepressant drugs are being taken at the same time.
  • Increasing the dose of the new antidepressant drug to a therapeutic dose after you have stopped taking the original antidepressant drug.

When is cross tapering most commonly used to switch antidepressants?

Cross-tapering is commonly used for patients at high-risk of a relapse of their depression, where there is a risk of drug interaction and increased side effects when the antidepressants are combined.

Cross-tapering is not suitable for antidepressant switches involving a monoamine-oxidase inhibitor (MAOI), which require a washout period between antidepressants.

What other strategies are used when switching antidepressants?

The other strategies used when switching from one antidepressant to another involve stopping the current antidepressant drug before starting the new one.

A conservative switch involves stopping the current antidepressant drug and waiting five half-lives of that drug - the washout period - before starting the new antidepressant according to the prescribing information.

A moderate switch involves a drug-free washout period of 2-4 days before starting the new antidepressant drug at a low dose.

A direct switch involves stopping the first antidepressant one day and starting the new one at the usual therapeutic dose the next day.

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antidepressant, tapering, antidepressants

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