Stopping long term antidepressants

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Goodfellow Gems

Stopping long term antidepressants

In this trial, patients had a history of at least two depressive episodes or took antidepressants for two years or longer and felt well enough to consider stopping them.1 Patients were randomly assigned to maintain their current antidepressant therapy (maintenance group) or to taper and discontinue using a placebo (discontinuation group).

By 52 weeks, relapse occurred in 92 of 238 patients (39%) in the maintenance group and 56% in the discontinuation group. The NNT for this study was 6.

An unpublished NZ study in primary care found a similar result, 23.3% relapse in the discontinuation and 10.5% in the maintenance group (NNT = 7.8).

If patients are interested in withdrawing from long-term antidepressants, many can likely do this successfully, but a proportion will feel the need to re-start their medication. 

References:

  1. Maintenance or Discontinuation of Antidepressants in Primary Care. N Engl J Med (2021) View here
  2. Mangin D, et al. The effectiveness of maintenance SSRI treatment in primary care depression to prevent recurrence. Proceedings of the 2015 NAPCRG Group 43rd Annual Meeting.

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.



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