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Goal: Exfoliate https://lookaside.fbsbx.com/lookaside/crawler/media/?media_id=806690964799895 Vitamin B12 Methylcobalamin 2000mcg | VIAVQ Vitamin – VIAVQ VITAMIN Height:4mm when switching between monoamine-oxidase inhibitor (MAOI) or moclobemide (a reversible inhibitor of monoamine-oxidase type A- RIMA) and other antidepressants, the first antidepressant agent should be withdrawn gradually and discontinued before starting the second antidepressant for switches that involve a MAOI, a washout period is always advised patients should be assessed on an individual basis to determine how quickly the switch can be made by assessing history of discontinuation reactions, concurrent medication and severity of depression the potential for medication errors should be considered MAOI discontinuation syndrome (2): reactions to MAOI discontinuation, particularly those reported with tranylcypromine, tend to be more severe than with other antidepressants (2) features may include: (i) a worsening of depressive symptoms, exceeding the severity of the state that originally led to treatment (ii) an acute confusional state with disorientation, paranoid delusions and hallucinations (iii) anxiety symptoms, including hyperacusis and depersonalisation Non-reversible MAOIs, such as phenelzine, combined antidepressants and lithium augmentation of antidepressants should normally be prescribed only by specialist mental health professionals (3) when switching from a non-reversible MAOI: a 2-week washout period is required (do not routinely prescribe other antidepressants during this period) (3) 3 weeks with clomipramine or imipramine (4)