PT  - JOURNAL ARTICLE
AU  - Rhona Eveleigh
AU  - Esther Muskens
AU  - Peter Lucassen
AU  - Peter Verhaak
AU  - Jan Spijker
AU  - Chris van Weel
AU  - Richard Oude Voshaar
AU  - Anne Speckens
TI  - Withdrawal of unnecessary antidepressant medication: a randomised controlled trial in primary care
AID  - 10.3399/bjgpopen17X101265
DP  - 2018 Jan 01
TA  - BJGP Open
PG  - bjgpopen17X101265
VI  - 1
IP  - 4
4099  - http://bjgpopen.org/content/1/4/bjgpopen17X101265.short
4100  - http://bjgpopen.org/content/1/4/bjgpopen17X101265.full
SO  - BJGP Open2018 Jan 01; 1
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.