SwitchAntipsychotics

Switching Antipsychotics (part of www.psychiatrienet.nl)

To see the consequences of a switch between antipsychotics click in the crosstable below: the switch is made "from" (vertical) "to" (horizontal).
During switching: don't reduce anticholinergics; consider adding oxazepam. Read: General considerations concerning switching antipsychotics.

Rest AP = Chlorprothixene, Flupentixol, Loxapine, Paliperidone, Pericyazine, Perphenazine,Promazine, Trifluoperazine, Zuclopentixol.

Partial antagonist new = Aripiprazole, Brexpiprazole, Cariprazine.

↓ from	to →	Start	Am	Cp	Hp	Lu	Ol	Pa	Pi	Qu	Rd	Sd	Sr	Zi	RA	Da	Df	Di	Dh	Do	Dp	Dr	Dz	Mz	{{{afk23}}}	{{{afk24}}}	Stop
Am	Amisulpride	–Am	—	AmCp	AmHp	AmLu	AmOl	AmPa	AmPi	AmQu	AmRd	AmSd	AmSr	AmZi	AmRA	AmDa	AmDf	AmDi	AmDh	AmDo	AmDp	AmDr	AmDz	AmMz	[[Amisulpride-{{{med23}}}|Am{{{afk23}}}]]	[[Amisulpride-{{{med24}}}|Am{{{afk24}}}]]	Am–
Cp	Clozapine	–Cp	CpAm	—	CpHp	CpLu	CpOl	CpPa	CpPi	CpQu	CpRd	CpSd	CpSr	CpZi	CpRA	CpDa	CpDf	CpDi	CpDh	CpDo	CpDp	CpDr	CpDz	CpMz	[[Clozapine-{{{med23}}}|Cp{{{afk23}}}]]	[[Clozapine-{{{med24}}}|Cp{{{afk24}}}]]	Cp–
Hp	Haloperidol	–Hp	HpAm	HpCp	—	HpLu	HpOl	HpPa	HpPi	HpQu	HpRd	HpSd	HpSr	HpZi	HpRA	HpDa	HpDf	HpDi	HpDh	HpDo	HpDp	HpDr	HpDz	HpMz	[[Haloperidol-{{{med23}}}|Hp{{{afk23}}}]]	[[Haloperidol-{{{med24}}}|Hp{{{afk24}}}]]	Hp–
Lu	Lurasidone	–Lu	LuAm	LuCp	LuHp	—	LuOl	LuPa	LuPi	LuQu	LuRd	LuSd	LuSr	LuZi	LuRA	LuDa	LuDf	LuDi	LuDh	LuDo	LuDp	LuDr	LuDz	LuMz	[[Lurasidone-{{{med23}}}|Lu{{{afk23}}}]]	[[Lurasidone-{{{med24}}}|Lu{{{afk24}}}]]	Lu–
Ol	Olanzapine	–Ol	OlAm	OlCp	OlHp	OlLu	—	OlPa	OlPi	OlQu	OlRd	OlSd	OlSr	OlZi	OlRA	OlDa	OlDf	OlDi	OlDh	OlDo	OlDp	OlDr	OlDz	OlMz	[[Olanzapine-{{{med23}}}|Ol{{{afk23}}}]]	[[Olanzapine-{{{med24}}}|Ol{{{afk24}}}]]	Ol–
Pa	Partial agonist	–Pa	PaAm	PaCp	PaHp	PaLu	PaOl	—	PaPi	PaQu	PaRd	PaSd	PaSr	PaZi	PaRA	PaDa	PaDf	PaDi	PaDh	PaDo	PaDp	PaDr	PaDz	PaMz	[[Partial agonist-{{{med23}}}|Pa{{{afk23}}}]]	[[Partial agonist-{{{med24}}}|Pa{{{afk24}}}]]	Pa–
Pi	Pimozide	–Pi	PiAm	PiCp	PiHp	PiLu	PiOl	PiPa	—	PiQu	PiRd	PiSd	PiSr	PiZi	PiRA	PiDa	PiDf	PiDi	PiDh	PiDo	PiDp	PiDr	PiDz	PiMz	[[Pimozide-{{{med23}}}|Pi{{{afk23}}}]]	[[Pimozide-{{{med24}}}|Pi{{{afk24}}}]]	Pi–
Qu	Quetiapine	–Qu	QuAm	QuCp	QuHp	QuLu	QuOl	QuPa	QuPi	—	QuRd	QuSd	QuSr	QuZi	QuRA	QuDa	QuDf	QuDi	QuDh	QuDo	QuDp	QuDr	QuDz	QuMz	[[Quetiapine-{{{med23}}}|Qu{{{afk23}}}]]	[[Quetiapine-{{{med24}}}|Qu{{{afk24}}}]]	Qu–
Rd	Risperidone	–Rd	RdAm	RdCp	RdHp	RdLu	RdOl	RdPa	RdPi	RdQu	—	RdSd	RdSr	RdZi	RdRA	RdDa	RdDf	RdDi	RdDh	RdDo	RdDp	RdDr	RdDz	RdMz	[[Risperidone-{{{med23}}}|Rd{{{afk23}}}]]	[[Risperidone-{{{med24}}}|Rd{{{afk24}}}]]	Rd–
Sd	Sertindole	–Sd	SdAm	SdCp	SdHp	SdLu	SdOl	SdPa	SdPi	SdQu	SdRd	—	SdSr	SdZi	SdRA	SdDa	SdDf	SdDi	SdDh	SdDo	SdDp	SdDr	SdDz	SdMz	[[Sertindole-{{{med23}}}|Sd{{{afk23}}}]]	[[Sertindole-{{{med24}}}|Sd{{{afk24}}}]]	Sd–
Sr	Sulpiride	–Sr	SrAm	SrCp	SrHp	SrLu	SrOl	SrPa	SrPi	SrQu	SrRd	SrSd	—	SrZi	SrRA	SrDa	SrDf	SrDi	SrDh	SrDo	SrDp	SrDr	SrDz	SrMz	[[Sulpiride-{{{med23}}}|Sr{{{afk23}}}]]	[[Sulpiride-{{{med24}}}|Sr{{{afk24}}}]]	Sr–
Zi	Ziprasidone	–Zi	ZiAm	ZiCp	ZiHp	ZiLu	ZiOl	ZiPa	ZiPi	ZiQu	ZiRd	ZiSd	ZiSr	—	ZiRA	ZiDa	ZiDf	ZiDi	ZiDh	ZiDo	ZiDp	ZiDr	ZiDz	ZiMz	[[Ziprasidone-{{{med23}}}|Zi{{{afk23}}}]]	[[Ziprasidone-{{{med24}}}|Zi{{{afk24}}}]]	Zi–
RA	Rest AP	–RA	RAAm	RACp	RAHp	RALu	RAOl	RAPa	RAPi	RAQu	RARd	RASd	RASr	RAZi	—	RADa	RADf	RADi	RADh	RADo	RADp	RADr	RADz	RAMz	[[Rest AP-{{{med23}}}|RA{{{afk23}}}]]	[[Rest AP-{{{med24}}}|RA{{{afk24}}}]]	RA–
Da	Aripiprazole_LA	–Da	DaAm	DaCp	DaHp	DaLu	DaOl	DaPa	DaPi	DaQu	DaRd	DaSd	DaSr	DaZi	DaRA	—	DaDf	DaDi	DaDh	DaDo	DaDp	DaDr	DaDz	DaMz	[[Aripiprazole_LA-{{{med23}}}|Da{{{afk23}}}]]	[[Aripiprazole_LA-{{{med24}}}|Da{{{afk24}}}]]	Da–
Df	Fluphenazine_LA	–Df	DfAm	DfCp	DfHp	DfLu	DfOl	DfPa	DfPi	DfQu	DfRd	DfSd	DfSr	DfZi	DfRA	DfDa	—	DfDi	DfDh	DfDo	DfDp	DfDr	DfDz	DfMz	[[Fluphenazine_LA-{{{med23}}}|Df{{{afk23}}}]]	[[Fluphenazine_LA-{{{med24}}}|Df{{{afk24}}}]]	Df–
Di	Flupenthixol_LA	–Di	DiAm	DiCp	DiHp	DiLu	DiOl	DiPa	DiPi	DiQu	DiRd	DiSd	DiSr	DiZi	DiRA	DiDa	DiDf	—	DiDh	DiDo	DiDp	DiDr	DiDz	DiMz	[[Flupenthixol_LA-{{{med23}}}|Di{{{afk23}}}]]	[[Flupenthixol_LA-{{{med24}}}|Di{{{afk24}}}]]	Di–
Dh	Haloperidol_LA	–Dh	DhAm	DhCp	DhHp	DhLu	DhOl	DhPa	DhPi	DhQu	DhRd	DhSd	DhSr	DhZi	DhRA	DhDa	DhDf	DhDi	—	DhDo	DhDp	DhDr	DhDz	DhMz	[[Haloperidol_LA-{{{med23}}}|Dh{{{afk23}}}]]	[[Haloperidol_LA-{{{med24}}}|Dh{{{afk24}}}]]	Dh–
Do	Olanzapine_LA	–Do	DoAm	DoCp	DoHp	DoLu	DoOl	DoPa	DoPi	DoQu	DoRd	DoSd	DoSr	DoZi	DoRA	DoDa	DoDf	DoDi	DoDh	—	DoDp	DoDr	DoDz	DoMz	[[Olanzapine_LA-{{{med23}}}|Do{{{afk23}}}]]	[[Olanzapine_LA-{{{med24}}}|Do{{{afk24}}}]]	Do–
Dp	Paliperidone_LA	–Dp	DpAm	DpCp	DpHp	DpLu	DpOl	DpPa	DpPi	DpQu	DpRd	DpSd	DpSr	DpZi	DpRA	DpDa	DpDf	DpDi	DpDh	DpDo	—	DpDr	DpDz	DpMz	[[Paliperidone_LA-{{{med23}}}|Dp{{{afk23}}}]]	[[Paliperidone_LA-{{{med24}}}|Dp{{{afk24}}}]]	Dp–
Dr	Risperidone_LA	–Dr	DrAm	DrCp	DrHp	DrLu	DrOl	DrPa	DrPi	DrQu	DrRd	DrSd	DrSr	DrZi	DrRA	DrDa	DrDf	DrDi	DrDh	DrDo	DrDp	—	DrDz	DrMz	[[Risperidone_LA-{{{med23}}}|Dr{{{afk23}}}]]	[[Risperidone_LA-{{{med24}}}|Dr{{{afk24}}}]]	Dr–
Dz	Zuclopenthixol_LA	–Dz	DzAm	DzCp	DzHp	DzLu	DzOl	DzPa	DzPi	DzQu	DzRd	DzSd	DzSr	DzZi	DzRA	DzDa	DzDf	DzDi	DzDh	DzDo	DzDp	DzDr	—	DzMz	[[Zuclopenthixol_LA-{{{med23}}}|Dz{{{afk23}}}]]	[[Zuclopenthixol_LA-{{{med24}}}|Dz{{{afk24}}}]]	Dz–
Mz	Zuclopenthixol_MA	–Mz	MzAm	MzCp	MzHp	MzLu	MzOl	MzPa	MzPi	MzQu	MzRd	MzSd	MzSr	MzZi	MzRA	MzDa	MzDf	MzDi	MzDh	MzDo	MzDp	MzDr	MzDz	—	[[Zuclopenthixol_MA-{{{med23}}}|Mz{{{afk23}}}]]	[[Zuclopenthixol_MA-{{{med24}}}|Mz{{{afk24}}}]]	Mz–
{{{afk23}}}		–{{{afk23}}}	[[{{{med23}}}-Amisulpride|{{{afk23}}}Am]]	[[{{{med23}}}-Clozapine|{{{afk23}}}Cp]]	[[{{{med23}}}-Haloperidol|{{{afk23}}}Hp]]	[[{{{med23}}}-Lurasidone|{{{afk23}}}Lu]]	[[{{{med23}}}-Olanzapine|{{{afk23}}}Ol]]	[[{{{med23}}}-Partial agonist|{{{afk23}}}Pa]]	[[{{{med23}}}-Pimozide|{{{afk23}}}Pi]]	[[{{{med23}}}-Quetiapine|{{{afk23}}}Qu]]	[[{{{med23}}}-Risperidone|{{{afk23}}}Rd]]	[[{{{med23}}}-Sertindole|{{{afk23}}}Sd]]	[[{{{med23}}}-Sulpiride|{{{afk23}}}Sr]]	[[{{{med23}}}-Ziprasidone|{{{afk23}}}Zi]]	[[{{{med23}}}-Rest AP|{{{afk23}}}RA]]	[[{{{med23}}}-Aripiprazole_LA|{{{afk23}}}Da]]	[[{{{med23}}}-Fluphenazine_LA|{{{afk23}}}Df]]	[[{{{med23}}}-Flupenthixol_LA|{{{afk23}}}Di]]	[[{{{med23}}}-Haloperidol_LA|{{{afk23}}}Dh]]	[[{{{med23}}}-Olanzapine_LA|{{{afk23}}}Do]]	[[{{{med23}}}-Paliperidone_LA|{{{afk23}}}Dp]]	[[{{{med23}}}-Risperidone_LA|{{{afk23}}}Dr]]	[[{{{med23}}}-Zuclopenthixol_LA|{{{afk23}}}Dz]]	[[{{{med23}}}-Zuclopenthixol_MA|{{{afk23}}}Mz]]	—	[[{{{med23}}}-{{{med24}}}|{{{afk23}}}{{{afk24}}}]]	{{{afk23}}}–
{{{afk24}}}		–{{{afk24}}}	[[{{{med24}}}-Amisulpride|{{{afk24}}}Am]]	[[{{{med24}}}-Clozapine|{{{afk24}}}Cp]]	[[{{{med24}}}-Haloperidol|{{{afk24}}}Hp]]	[[{{{med24}}}-Lurasidone|{{{afk24}}}Lu]]	[[{{{med24}}}-Olanzapine|{{{afk24}}}Ol]]	[[{{{med24}}}-Partial agonist|{{{afk24}}}Pa]]	[[{{{med24}}}-Pimozide|{{{afk24}}}Pi]]	[[{{{med24}}}-Quetiapine|{{{afk24}}}Qu]]	[[{{{med24}}}-Risperidone|{{{afk24}}}Rd]]	[[{{{med24}}}-Sertindole|{{{afk24}}}Sd]]	[[{{{med24}}}-Sulpiride|{{{afk24}}}Sr]]	[[{{{med24}}}-Ziprasidone|{{{afk24}}}Zi]]	[[{{{med24}}}-Rest AP|{{{afk24}}}RA]]	[[{{{med24}}}-Aripiprazole_LA|{{{afk24}}}Da]]	[[{{{med24}}}-Fluphenazine_LA|{{{afk24}}}Df]]	[[{{{med24}}}-Flupenthixol_LA|{{{afk24}}}Di]]	[[{{{med24}}}-Haloperidol_LA|{{{afk24}}}Dh]]	[[{{{med24}}}-Olanzapine_LA|{{{afk24}}}Do]]	[[{{{med24}}}-Paliperidone_LA|{{{afk24}}}Dp]]	[[{{{med24}}}-Risperidone_LA|{{{afk24}}}Dr]]	[[{{{med24}}}-Zuclopenthixol_LA|{{{afk24}}}Dz]]	[[{{{med24}}}-Zuclopenthixol_MA|{{{afk24}}}Mz]]	[[{{{med24}}}-{{{med23}}}|{{{afk24}}}{{{afk23}}}]]	—	{{{afk24}}}–

LA = long acting, MA = medium acting

(part of www.psychiatrienet.nl)