showed that there are small differences in efficacy between antipsychotics however they differ substantially in regard to side effects. 2012 Dec 4;12:218. doi: 10.1186/1471-244X-12-218.CNS Neurosci Ther. As more and more second-generation antipsychotics are introduced, the need for practical guidelines on switching these medications becomes increasingly important. Illness severity, relapse history (including history of suicidal, violent, or other dangerous behaviors), tolerance of previous antipsychotic switches, current level of clinical stability, level of insight, and psychosocial support are all important factors.In general, greater urgency for switching antipsychotics favors abrupt discontinuation or a very rapid cross-taper (over a period of only a few days). Compare Rocaltrol head-to-head with other drugs for uses, ratings, cost, side effects, interactions and more. Repeated episodes of psychosis worsen longer term prognosis. doi: 10.2165/00023210-200519010-00003. Rocaltrol rated 10.0/10 in overall patient satisfaction. An assessment of patient readiness for a full therapeutic trial of the post-switch antipsychotic is important. This usually involves a period of both drugs being used simultaneously. Regardless of the reasons for switching, specific and agreed-on target objectives; judicious selection of post-switch antipsychotics and switch strategies; careful follow-up and evaluation of progress toward achieving the goals of switching during the post-switch period; and close communication with the patient, caregivers, and treatment team members during every phase of the switch process will help minimize risk and optimize clinical outcome.William V. Bobo, MD, MPH, has received research support from the NIMH, NARSAD, and Cephalon, Inc. These may represent adverse effects of the new medication, rebound effects due to withdrawal of the pre-switch antipsychotic, or general anxiety about switching antipsychotics. Overlap and discontinuation may be a very good option for patients who require an antipsychotic switch but are not yet fully stabilized with the pre-switch antipsychotic or for those who are prone to severe psychotic symptoms or dangerous behaviors if they are under-medicated during a medication switch. Switching Antipsychotics (part of www.switchwiki.eu; an app ('switchtabellen') is available) To see the consequences of a switch between antipsychotics click in the crosstable below: the switch is made "from" (vertical) "to" (horizontal). Occasionally, situations are encountered in which the risk-benefit assessment clearly favors switching antipsychotics, such as when a given medication is clearly ineffective or when severe adverse effects arise. Ideally, the initial target symptoms, adverse effects, and other factors identified and documented during the pre-switch period will be improved, thus providing evidence that the specific objectives of the antipsychotic switch have been attained.Common problems that arise during the early post-switch period include increased psychotic symptoms, anxiety, agitation, insomnia, and extrapyramidal effects. Switching from an oral to long-acting injectable antipsychotic is often easy to carry out in most clinical settings. Although these patients may also benefit from switching antipsychotics, this still represents a major therapeutic change that carries the risk of clinical worsening.On the basis of controlled evidence, switching from metabolically higher-risk antipsychotics to lower-risk agents in patients who experience clinically significant weight gain, hyperglycemia, or atherogenic dyslipidemia with their current antipsychotic is an option worth considering if other management options are ineffective or not feasible.