'''General considerations'''

# The goal of this switching table is to offer a guide for physician and pharmacist in switching antipsychotics. The table should be clear, easy to use and contain the most important information. Therefore, the table only contains the most common or special antipsychotics. There is also a group ‘rest AP’, containing antipsychotics with the same switching advice.

# Because of the risk of acute withdrawal symptoms (e.g. cholinergic rebound) and the risk of relapse, all antipsychotics are gradually tapered.

# The standard tapering period is approximately two weeks. The two drugs are cross-tapered, reducing and increasing the dose with approximately 25% every 2-3 days.

# Switching from a drug with a short half life to a drug with a long half life is possibly more problematic. Plasma levels of the first drug decrease rapidly, while the second drug takes longer to reach a steady state plasma level. To overcome possible withdrawal/ relapse, the second drug should be started in a higher dose (approx. 50% of target dose) for about 4 days. Subsequently increase with 25% every 3-4 days.

# Warnings and advice are limited to the switch only. Specific drug properties can be found via the links on the right.

# Nearly all antipsychotics increase the risk of QT time prolongation with or without Torsade de Pointes (TDP). Under the heading ‘more information’ there is a recommendation, advising ECG monitoring. The SPC of sertindole contains the warning ECG monitoring required. No distinction has been made between drugs with and without TDP.

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