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Switching antidepressant - SNRI (e.g. duloxetine or venlafaxine) to monoamine oxidase inhibitors (MAOIs) in adults

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SNRIs to monoamine oxidase inhibitors (MAOIs)

Specialist advice is indicated because MAOI is always a complex switch.

Taper, washout and switch with specialist advice

  • for any SNRI, you should gradually reduce the dose and then stop. You will need to wait a period, dependent on the antidepressant being switched from (see below), before starting MAOI
  • specialist will advise the duration of the washout period on a case-by-case basis taking into consideration the MAOI being started.

Cross-tapering is not recommended due to the high risk of serotonin syndrome.

From duloxetine

  • after stopping duloxetine, wait 5 to 14 days before starting the MAOI.

From venlafaxine

  • after stopping venlafaxine, wait 7 to 14 days before starting the MAOI.

Reference:

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