1. Be clear about your reason(s) for wanting to switch antidepressants. Is it that the side effects are intolerable, or is it that you are not satisfied with the response? If you want to switch for the latter reason, you need to determine exactly what you mean and communicate that to your doctor. Did your antidepressant ever work fully? Bear in mind that you need to give the medication up to four weeks before you would definitely be seeing an improvement. Or did it lift your mood to some extent and then plateau? That's called a partial response. In first case, your doctor will probably be open to you switching to a new antidepressant. If it's the latter, however, your doctor may want to raise the dose or possibly augment your current antidepressant with another medication.
2. Have your details ready. Whether your dissatisfaction with your antidepressant is due to side effects or ineffectiveness, keeping good records will be very helpful to your doctor. Whenever you start a new medication, you should note the start date on the calendar. Then you will want to keep track both of your moods and of any side effects. You also want to track any new medications beyond your antidepressants, as some medications could make your antidepressant less effective. Have your calendar available for your doctor at each visit.
3. Do your homework. You should be well informed about antidepressants, especially about the one you've been taking. If you're interested in switching antidepressants, it would be helpful to both you and your doctor if you know what your other medication options are, and a little bit about how they work and what the possible side effects are. You and your doctors should be partners in your treatment.
4. Be open to other options. When I felt that my antidepressant was not working as well as it should, my doctor suggested taking folic acid supplements. It made a big difference. Your doctor may suggest a change in diet, exercise or stress reduction. Unless your depression is severe or you're suicidal, keep an open mind and give something a shot for at least a couple of weeks.
5. If you feel strongly about switching and your doctor isn't responsive, consider getting a second opinion. A good doctor is probably the single most important factor, in my opinion, in depression treatment and remission.