Skip to main content

Staying on long-term antidepressants reduces risk of relapse

Staying on long-term antidepressants reduces risk of relapse
When people stop taking antidepressants after a long period of use, just over half (56%) experience a relapse within a year, compared to 39% of those who stay on medication, finds a new study led by UCL researchers.

The researchers say their findings, published in The New England Journal of Medicine, can help doctors and patients to make an informed decision together on whether or not to stop their antidepressants after recovery from a depressive episode.

The study is the first publication from a large discontinuation trial of people taking antidepressants for multiple years in primary care.

Lead author Dr Gemma Lewis (UCL Psychiatry) said: “Prescriptions of antidepressants have increased dramatically over recent decades as people are now staying on antidepressants for much longer. Until now we didn’t know whether antidepressant treatment was still effective when someone has been taking them for many years.

“We have found that remaining on antidepressants long-term does effectively reduce the risk of relapse. However, many people can stop their medication without relapsing, though at present we cannot identify who those people are.”

The National Institute for Health Research-funded study involved 478 primary care patients in England who had been taking long-term antidepressants (citalopram, sertraline, fluoxetine, or mirtazapine) and who felt well enough to consider stopping. 70% had been taking the medication for more than three years.

In a randomised, double-blind controlled trial, half of the study participants stopped taking their medication and half continued. Those who discontinued their antidepressants were given reduced dosages for up to two months as part of a tapering regime, before being given placebo pills only.

Over the following year, 56% of participants who discontinued antidepressants experienced a relapse (a new episode of depression), compared to 39% of participants who kept taking them. Of the 56% who experienced relapse after discontinuation, only half then chose to return to an antidepressant prescribed by their clinician. The researchers say that some relapses, as well as possible withdrawal symptoms, might not have been severe enough for the person to decide they needed to return to their medication.

Those who discontinued their antidepressants were more likely to experience withdrawal symptoms. Despite this, by the end of the study, 59% of the discontinuation group were not taking antidepressants. 

Dr Gemma Lewis said: “Our findings add to evidence that for many patients, long-term treatment is appropriate, but we also found that many people were able to effectively stop taking their medication when it was tapered over two months.

“As 44% of those who discontinued their antidepressants did not relapse after a full year, our findings suggest that some patients might decide to stop their antidepressant, knowing the risk of relapse, but we recommend discussing this with your doctor.”

Senior author Professor Glyn Lewis (UCL Psychiatry) said: “Antidepressants are effective but, like many medications, are not ideal for everyone. In our study, 39% of people who continued on the medication still experienced a relapse, although stopping antidepressants increased the risk of relapse further. There are also other ways to prevent relapse that might help including cognitive behavioural and mindfulness-based therapies.”

Co-lead author Dr Louise Marston (UCL Institute of Epidemiology & Health Care) said: “We do not yet know why some people seem able to come off their antidepressants and some cannot, so further research may help us to predict who can stop antidepressants safely.”

Paul Lanham, lived experience co-researcher, said: “Many patients taking antidepressants long term have absolutely no idea what they would be like without antidepressants. Some will not want to find out, but others will. These results show that staying on antidepressants does reduce the risk of relapse, but it does not guarantee well-being, and some people can stop antidepressants without a relapse.”

The study involved researchers from UCL, the Universities of York, Southampton and Bristol, and McMaster University (Canada).



from ScienceBlog.com https://ift.tt/3zQjtrW
Labels:

Comments

Post a Comment

Popular posts from this blog

Wiggling worms suggest link between vitamin B12 and Alzheimer’s

Worms don’t wiggle when they have Alzheimer’s disease. Yet something helped worms with the disease hold onto their wiggle in Professor Jessica Tanis’s lab at the University of Delaware. In solving the mystery, Tanis and her team have yielded new clues into the potential impact of diet on Alzheimer’s, the dreaded degenerative brain disease afflicting more than 6 million Americans. A few years ago, Tanis and her team began investigating factors affecting the onset and progression of Alzheimer’s disease. They were doing genetic research with  C. elegans , a tiny soil-dwelling worm that is the subject of numerous studies. Expression of amyloid beta, a toxic protein implicated in Alzheimer’s disease, paralyzes worms within 36 hours after they reach adulthood. While the worms in one petri dish in Tanis’s lab were rendered completely immobile, the worms of the same age in the adjacent petri dish still had their wiggle, documented as “body bends,” by the scientists. “It was an observa...
Post a Comment
Read more

‘Massive-scale mobilization’ necessary for addressing climate change, scientists say

A year after a global coalition of more than 11,000 scientists declared a climate emergency, Oregon State University researchers who initiated the declaration released an update today that points to a handful of hopeful signs, but shares continued alarm regarding an overall lack of progress in addressing climate risks. “Young people in more than 3,500 locations around the world have organized to push for urgent action,” said Oregon State University’s William Ripple, who co-authored “The Climate Emergency: 2020 in Review,” published today in Scientific American. “And the Black Lives Matter movement has elevated social injustice and equality to the top of our consciousness. “Rapid progress in each of the climate action steps we outline is possible if framed from the outset in the context of climate justice – climate change is a deeply moral issue. We desperately need those who face the most severe climate risks to help shape the response.” One year ago, Ripple, distinguished profess...
Post a Comment
Read more

Ancient Shell Sounds

Abandoned at the mouth of your shelter you quivered apprehensively at our approach, crying out to be held as we proclaimed the exception of your discovery. Sighing wearily as we consigned you to the dusty silence of our archives. But now When I hold you in my hands, I see the face of your purposefully speckled complexion. When I lift you to my ear, I hear the sound of an ancient sea lapping at your shores. When I place you at my lips, I feel the heartbeat of your creator pulsing to my breath. I close my eyes, as you call out to all that you have lost. The shell that was recovered from the Marsoulas cave in the Pyrenees of France (Image Credit: C. Fritz, Muséum d’Histoire naturelle de Toulouse). This poem is inspired by recent research , which has discovered that a large seashell that sat in a French museum for decades is actually a musical instrument used around 18,000 years ago. In 1931, researchers working in southern France unearthed a large seashell at the entr...
Post a Comment
Read more