From sertraline to escitalopram

[matrix123]

Hi everyone, I've been on/off medication a few times in last 10 years (mostly escitalopram and last 2 times sertraline). I got back on sertraline 2 months ago and I don't see any improvement, only getting worse. Talked to the doc and she suggested to switch to escitalopram. Initially escitalopram worked great for me, but after being off/on I felt it wasn't working that good (however sertraline it's not working at all).

Do you think it's a good choice to go back on escitalopram? If so, is it better to tapper of sertraline and start at the same time escitalopram (I'm at 100mg sertraline, so it would be 50mg sertraline and 5 mg escitalopram, then after 5 days no sertraline 10mg escitalopram and after 10 days 20mg escitalopram)? Or to tapper of sertraline for 5 days and then start escitalopram?

Thank you

[panic_down_under]

Do you think it's a good choice to go back on escitalopram?

I would have suggested switching to a TCA, either amitriptyline, or imipramine, but is SSRIs are preferable than escitalopram is as likely to work as another SSRI. It and citalopram have good records for working when another SSRI has failed, though your previous use may reduce the chances a little.


If so, is it better to tapper of sertraline and start at the same time escitalopram (I'm at 100mg sertraline, so it would be 50mg sertraline and 5 mg escitalopram, then after 5 days no sertraline 10mg escitalopram and after 10 days 20mg escitalopram)? Or to tapper of sertraline for 5 days and then start escitalopram?

You're likely to do okay with the cross taper option, or you could do an overnight switch from 100mg sertraline to 10mg escitalopram increasing the dose to 20mg escitalopram after a week. There is no need to taper off one SSRI before starting another (or a TCA). This only delays the recovery for little if any gain, ime.

[matrix123]

Thank you for your feedback. Overnight switch to 10mg escitalopram made sense to me as well. Maybe the doc was overcautious, but with the "epxerience" I have, I think I can manage the switch.

[Phill2]

I cross tapered with no side effects.
Worked well for me.


Hi everyone, I've been on/off medication a few times in last 10 years (mostly escitalopram and last 2 times sertraline). I got back on sertraline 2 months ago and I don't see any improvement, only getting worse. Talked to the doc and she suggested to switch to escitalopram. Initially escitalopram worked great for me, but after being off/on I felt it wasn't working that good (however sertraline it's not working at all).

Do you think it's a good choice to go back on escitalopram? If so, is it better to tapper of sertraline and start at the same time escitalopram (I'm at 100mg sertraline, so it would be 50mg sertraline and 5 mg escitalopram, then after 5 days no sertraline 10mg escitalopram and after 10 days 20mg escitalopram)? Or to tapper of sertraline for 5 days and then start escitalopram?

Thank you

[panic_down_under]

Maybe the doc was overcautious, but with the "epxerience" I have, I think I can manage the switch.

You can always backtrack if you run into problems.