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Switching medications

Why switch medications?

Achieving an optimum pharmacological response may require switching medications. Reasons for switching include individual differences in response, sensitivity to side effects, and peculiaraties of schizophrenia such as changes in symptoms over time.

What is the evidence for switching medications?

Moderate to high quality evidence from mirror-image studies finds fewer hospitalisations after switching from oral to long-acting injectable antipsychotics.

Moderate to high quality evidence finds no differences in symptoms between rapid or slow initiation while switching from one antipsychotic to another in stable patients. However, rapid initiation resulted in more all-cause discontinuation and more nausea.

High quality evidence finds no differences in symptoms between immediate, gradual or delaying discontinuation while switching antipsychotic medications. When switching to olanzapine, there was less insomnia with gradual discontinuation. When switching to ziprasidone, there were less parkinsonism symptoms with gradual discontinuation, but more somnolence.

October 2019

Last updated at: 4:41 am, 7th November 2019
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Fact Sheet Technical Commentary

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Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.