SSRIs to moclobemide
Taper, washout and switch
- for any SSRI, you should gradually reduce the dose and stop
- will then need to wait for a period, dependent on the antidepressant being switched from (see below), before starting moclobemide.
Cross-tapering is not recommended due to the high risk of serotonin syndrome.
From all except fluoxetine and sertraline
- after stopping the SSRI, wait 7 days before starting moclobemide.
From fluoxetine
- after stopping fluoxetine, wait 5 to 6 weeks before starting moclobemide
- clinicians should decide the duration of the washout period on a case-by-case basis
- fluoxetine may still cause medicine interactions 5 or 6 weeks after stopping, as fluoxetine and its active metabolite have a long half-life
From sertraline
- after stopping sertraline, wait 7 to 13 days before starting moclobemide
- manufacturer advises a 7 day washout period but 13 days may be considered to account for the long half-life of sertraline's active metabolite
- clinicians should decide the duration of the washout period on a case-by-case basis
Reference: