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Antidepressant switching — GPhC CRA MCQ

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HardCNS TherapeuticsAntidepressant switchingGPhC CRA

A 28-year-old woman taking fluoxetine 40 mg daily is prescribed moclobemide by a private clinic for depression. She stopped fluoxetine yesterday because she felt it was ineffective. What is the most appropriate action?

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Correct answer: E — Query the prescription because an adequate washout is needed after fluoxetine before MAOI therapy

Fluoxetine has a long half-life and active metabolite, so interaction risk persists after stopping. Combining or closely sequencing serotonergic antidepressants and MAOIs can cause serious toxicity. The prescriber should review washout timing and treatment plan. The pharmacist should not recommend herbal serotonergic products or substitute antidepressants independently.

Reference: BNF