TABLE 4

Risk of antidepressant discontinuation syndrome (ADS): A summary of antidepressant dosing

Risk of ADSName (brand name)Starting daily dose (mg)Daily dose range (mg)Typical dose increment (mg) (conservative dose increment)
LowBupropion XL (Wellbutrin XL)a150150–450150
Doxepin (Silenor)33–63
Fluoxetine (Prozac)a1010–8010
Levomilnacipran (Savella)2020–12040 (20)
Milnacipran (Fetzima)2550–30025–50 (12.5)
Vilazodone (Viibryd)1010–4010
Citalopram (Celexa)1010–4010
Escitalopram (Lexapro)55–3010 (5)
Mirtazapine (Remeron)7.5–157.5–6015 (7.5)
IntermediateSertraline (Zoloft)2525–30050 (12.5–25)
Trazodone (Deseryl)25–5025–40050 (25)
Vortioxetine (Trintellix)55–205
Amitriptyline (Elavil)10–2510–30050 (10–25)
Clomipramine (Anafranil)2525–30050 (25)
Desipramine (Norpramin)2525–30025–50 (10–25)
Desvenlafaxine (Pristiq)2550–40050 (25)
Doxepin (Sinequan)2525–30025–50 (10–25)
Duloxetine DR (Cymbalta DR)20–3030–12030 (20)
HighFluvoxamine (Luvox)b2525–30050 (12.5–25)
Imipramine (Tofranil)2525–30025–50 (10–25)
Nortriptyline (Pamelor)10–5010–15025–50 (10–25)
Paroxetine (Paxil)a1010–5010 (5)
Phenelzine (Nardil)157.5–9015
Tranylcypromine (Parnate)1010–6010
Venlafaxine ER (Effexor ER)37.575–37537.5
  • a Potent CYP 2D6 inhibitor.

  • b Potent CYP 1A2 inhibitor.