RT Journal Article
SR Electronic
T1 Withdrawal of unnecessary antidepressant medication: a randomised controlled trial in primary care
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP bjgpopen17X101265
DO 10.3399/bjgpopen17X101265
VO 1
IS 4
A1 Eveleigh, Rhona
A1 Muskens, Esther
A1 Lucassen, Peter
A1 Verhaak, Peter
A1 Spijker, Jan
A1 van Weel, Chris
A1 Oude Voshaar, Richard
A1 Speckens, Anne
YR 2018
UL http://bjgpopen.org/content/1/4/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.