Withdrawal of unnecessary antidepressant medication: a randomised controlled trial in primary care

Eveleigh, R., Muskens, E., Lucassen, P., Verhaak, P., Spijker, J., van Weel, C., Oude Voshaar, R. & Speckens, A., Jan-2018, In : BJGP open. 1, 4, 11 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • Rhona Eveleigh
  • Esther Muskens
  • Peter Lucassen
  • Peter Verhaak
  • Jan Spijker
  • Chris van Weel
  • Richard Oude Voshaar
  • Anne Speckens

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.

Original languageEnglish
Number of pages11
JournalBJGP open
Issue number4
Publication statusPublished - Jan-2018

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