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Relapse Risk Up With Antidepressant Therapy Discontinuation

Relapse occurred in fewer patients who maintained their antidepressant treatment versus those with discontinuation

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WEDNESDAY, Sept. 29, 2021 (HealthDay News) -- For patients with depression who feel well enough to discontinue antidepressant therapy, the risk for relapse is increased for those who discontinue their medication, according to a study published in the Sept. 30 issue of the New England Journal of Medicine.

Gemma Lewis, Ph.D., from University College London, and colleagues conducted a randomized trial involving adults treated in 150 general practices in the United Kingdom. Participants who had received citalopram, fluoxetine, sertraline, or mirtazapine and felt well enough to consider stopping antidepressants were randomly assigned to either maintain their current antidepressant therapy (maintenance) or taper and discontinue such treatment (discontinuation group) in a 1:1 ratio (238 and 240 patients, respectively).

The researchers found that adherence to the trial assignment was 70 and 52 percent in the maintenance and discontinuation groups, respectively. By 52 weeks, relapse occurred in 39 and 56 percent of patients in the maintenance and discontinuation groups, respectively (hazard ratio, 2.06). In general, secondary outcomes were in the same direction as the primary outcome. More symptoms of depression, anxiety, and withdrawal were seen in the discontinuation group versus the maintenance group.

"How do these results affect practice? They confirm what most primary care physicians already knew or intuited," writes the author of an accompanying editorial. "The results of this and many other trials highlight the fact that current treatment options for depressed patients are not ideal."

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