Staying on long-term antidepressants reduces threat of relapse

Staying on long-term antidepressants reduces threat of relapse

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When individuals cease taking antidepressants after an extended interval of use, simply over half (56%) expertise a relapse inside a 12 months, in comparison with 39% of those that keep on medicine, finds a brand new research led by UCL researchers.

The researchers say their findings, printed in The New England Journal of Drugs, may help medical doctors and sufferers to make an knowledgeable choice collectively on whether or not or to not cease their antidepressants after restoration from a depressive episode.

The research is the primary publication from a big discontinuation trial of individuals taking antidepressants for a number of years in major care.

Lead writer Dr. Gemma Lewis (UCL Psychiatry) mentioned: “Prescriptions of antidepressants have elevated dramatically over latest many years as individuals at the moment are staying on antidepressants for for much longer. Till now we did not know whether or not antidepressant remedy was nonetheless efficient when somebody has been taking them for a few years.

“We’ve got discovered that remaining on antidepressants long-term does successfully scale back the chance of relapse. Nonetheless, many individuals can cease their medicine with out relapsing, although at current we can’t determine who these individuals are.”

The Nationwide Institute for Well being Analysis-funded research concerned 478 major care sufferers in England who had been taking long-term antidepressants (citalopram, sertraline, fluoxetine, or mirtazapine) and who felt nicely sufficient to contemplate stopping. 70% had been taking the medicine for greater than three years.

In a randomized, double-blind managed trial, half of the research individuals stopped taking their medicine and half continued. Those that discontinued their antidepressants got lowered dosages for as much as two months as a part of a tapering regime, earlier than being given placebo capsules solely.

Over the next 12 months, 56% of individuals who discontinued antidepressants skilled a relapse (a brand new episode of despair), in comparison with 39% of individuals who saved taking them. Of the 56% who skilled relapse after discontinuation, solely half then selected to return to an antidepressant prescribed by their clinician. The researchers say that some relapses, in addition to attainable withdrawal signs, may not have been extreme sufficient for the individual to resolve they wanted to return to their medicine.

Those that discontinued their antidepressants had been extra prone to expertise withdrawal signs. Regardless of this, by the tip of the research, 59% of the discontinuation group weren’t taking antidepressants.

Dr. Gemma Lewis mentioned: “Our findings add to proof that for a lot of sufferers, long-term remedy is acceptable, however we additionally discovered that many individuals had been in a position to successfully cease taking their medicine when it was tapered over two months.

“As 44% of those that discontinued their antidepressants didn’t relapse after a full 12 months, our findings recommend that some sufferers would possibly resolve to cease their antidepressant, figuring out the chance of relapse, however we advocate discussing this along with your physician.”

Senior writer Professor Glyn Lewis (UCL Psychiatry) mentioned: “Antidepressants are efficient however, like many drugs, usually are not very best for everybody. In our research, 39% of people that continued on the medicine nonetheless skilled a relapse, though stopping antidepressants elevated the chance of relapse additional. There are additionally different methods to forestall relapse which may assist together with cognitive behavioral and mindfulness-based therapies.”

Co-lead writer Dr. Louise Marston (UCL Institute of Epidemiology & Well being Care) mentioned: “We don’t but know why some individuals appear in a position to come off their antidepressants and a few can’t, so additional analysis could assist us to foretell who can cease antidepressants safely.”

Paul Lanham, lived expertise co-researcher, mentioned: “Many sufferers taking antidepressants long run have completely no thought what they might be like with out antidepressants. Some won’t need to discover out, however others will. These outcomes present that staying on antidepressants does scale back the chance of relapse, nevertheless it doesn’t assure well-being, and a few individuals can cease antidepressants and not using a relapse.”

The research concerned researchers from UCL, the Universities of York, Southampton and Bristol, and McMaster College (Canada).


Pressing scarcity of proof for secure withdrawal from antidepressants


Extra info:
Upkeep or Discontinuation of Antidepressants in Major Care, New England Journal of Drugs (2021). DOI: 10.1056/NEJMoa2106356

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College School London


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retrieved 29 September 2021
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