RT Journal Article
SR Electronic
T1 Withdrawal of unnecessary antidepressant medication: a randomised controlled trial in primary care
JF BJGP Open
JO Br J Gen Pract Open
FD Royal College of General Practitioners
SP BJGP-2017-0169
DO 10.3399/bjgpopen17X101265
A1 Rhona Eveleigh
A1 Esther Muskens
A1 Peter Lucassen
A1 Peter Verhaak
A1 Jan Spijker
A1 Chris van Weel
A1 Richard Oude Voshaar
A1 Anne Speckens
YR 2017
UL http://bjgpopen.org/content/early/2017/11/14/bjgpopen17X101265.abstract
AB Background Antidepressant use has increased exponentially in recent decades, mostly due to long continuation.Aim To assess the effectiveness of a tailored recommendation to withdraw antidepressant treatment.Design & setting Randomised controlled trial in primary care (PANDA study) in the Netherlands.Method Long-term antidepressant users (≥9 months) were selected from GPs prescription databases. Patients were diagnosed with the Composite International Diagnostic Interview (CIDI). Long-term users without indication for maintenance treatment (overtreatment) were selected. The intervention consisted of disclosure of the current psychiatric diagnosis combined with a tailored treatment recommendation. Patients were followed for 12 months.Results The study included 146 participants from 45 family practices. Of the 70 patients in the intervention group, 34 (49%) did not comply with the advice to stop their antidepressant medication. Of the 36 (51%) patients who agreed to try, only 4 (6%) succeeded. These figures were consistent with the control group, where 6 (8%) of the 76 patients discontinued antidepressant use successfully. Patients who were recommended to discontinue their antidepressant medication reported a higher relapse rate than the control group (26% versus 13%, P = 0.05).Conclusion Changing inappropriate long-term antidepressant use is difficult.