After a depression, stopping a long-term antidepressant treatment leads to a relapse in more than half of the cases.
- Stopping antidepressant treatment is one of the main causes of relapse.
- Any decision to stop must be taken after the agreement of the attending physician.
- In France, the consumption of anti-depressants is 49.8 tablets per 1,000 inhabitants per day.
Depression is a common illness: according to data from theInserm, one in five people will be affected at least once in their lifetime. Generally, those affected are treated with anti-depressants. These drugs improve mood, while reducing certain symptoms, such as motor slowing. The treatment lasts a long time, at least six months and sometimes several years. Stopping medication is one of the main causes of relapse. Researchers from University College London have taken an interest in this problem in an article published in The New England Journal of Medicine.
What are the long term effects of antidepressants?
“Prescriptions for antidepressants have increased dramatically over the past few decades as people are now staying on treatment much longerexplains Dr. Gemma Lewis, lead author of this study. Until now, we did not know if antidepressant treatment was still effective when someone had been taking it for many years.“In this study, the team looked at 478 patients who were taking long-term antidepressants (citalopram, sertraline, fluoxetine or mirtazapine). All felt well enough to consider quitting, and 70% of them had been taking these drugs for more than three years.
Frequent relapses after stopping treatment
Two groups were created: in the first, people stopped their treatment, in the second, they continued it. Those who stopped their antidepressants were given reduced doses for two months, before being given only placebo pills. The trial was double-blind: neither the patients nor the doctors knew in which group the participants were placed. In the group stopping anti-depressants, 56% of patients experienced a relapse, that is to say a new episode of depression, against 39% in the group who continued treatment. Among those affected by relapse after stopping treatment, only half chose to resume anti-depressants. According to the researchers, some relapses or other withdrawal symptoms may not have been severe enough for the person to decide to resume medication.
Should I stop or continue the treatment?
“Our results demonstrate that for many patients, long-term treatment is appropriate, emphasizes Dr. Lewis, but we also found that many people were able to actually stop taking their medications when they were tapered over two months“In fact, almost half of the patients have not relapsed one year after quitting.”We don’t yet know why some people seem able to come off their antidepressants and others don’t.“, adds the co-author of the study, Dr. Louise Marston. The two scientists recommend that patients discuss this with their doctor before making the decision to stop or not.
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