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Rapid discontinuation of antidepressants reduces time to recurrence of depression and panic

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Question

Question

Does the rate of discontinuation of antidepressants affect the risk of illness recurrence?

Population

398 patients (137 men) with DSM-IV diagnosis of recurrent major depressive disorder, panic disorder, bipolar I or II disorder who had been treated with antidepressants for an average 8.5 months. Mean age was 41.9 years at antidepressant discontinuation.

Setting

Mood disorders centre affiliated with the University of Cagliari in Sardinia.

Prognostic factors

Rapid discontinuation (over 1-7 days) or gradual discontinuation (over 2 or more weeks).

Outcomes

Time to first new episode of depression or panic following treatment cessation.

Methods

Design

Cohort study.

Follow-up period

Mean follow-up 2.8 years (censored at 100 months).

Main results

62.6% of patients received tricyclic-like agents and 37.4% received other antidepressants during the index episode of major depression or panic. 188 patients discontinued their treatment rapidly and 210 discontinued gradually. 80.7% of patients decided to discontinue their own treatment, the remainder were advised by their prescribing clinician. Patients who were moderately clinically depressed, anxious or hypomanic at the time of …

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Footnotes

  • Sources of funding National Institute of Health, The Lucio Bini Private Donors Mood disorders Research Fund, The Bruce J. Anderson Foundation and the McLean Private Donors Psychopharmacology Research Fund

Footnotes

  • Competing interests TAF has received speaking fees from Astellas, Dai-Nippon Sumitomo, Eli Lilly, GlaxoSmithKline, Janssen, Kyorin, Meiji, Otsuka, Pfizer, Schering-Plough, Shionogi and Yoshitomi. He is on the research advisory board for Sekisui Chemicals and Takeda Science Foundation. He has received royalties from Igaku-Shoin, Seiwa-Shoten and Nihon Bunka Kagaku-sha.

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