Discontinuation of antidepressants: Is there a minimum time on treatment that will reduce relapse risk?. Liu, X., Momen, N., C., Molenaar, N., Rommel, A., Bergink, V., & Munk-Olsen, T. Journal of Affective Disorders, 290:254-260, 2021. ![Discontinuation of antidepressants: Is there a minimum time on treatment that will reduce relapse risk? [pdf]](https://bibbase.org/img/filetypes/pdf.svg "pdf")
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Website doi abstract bibtex Background: Several national guidelines include recommendations for a minimum duration of antidepressant treatment, but these vary from 4-9 months after remission. We aimed to investigate whether there is an optimal minimum duration of antidepressant treatment to reduce relapse risk. Methods: A Danish population-based cohort study among 89,442 adults who initiated antidepressants for depression treatment aged 18-60 years, from 2006-2015. We defined antidepressant discontinuation as ≥30 days without treatment. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) to indicate the risk of restarting antidepressants among those who discontinued antidepressants with <4, 4-6, and 7-9 months of use compared with discontinuation after 10-12 months. Results: For individuals on antidepressant treatment <4, 4-6, 7-9 and 10-12 months, cumulative incidence of restarting treatment within one year was 37.4% (95% CI: 36.9-37.8%), 35.1% (95% CI: 34.6-35.7%), 35.0% (95% CI: 34.2-35.8%) and 32.8% (95% CI: 31.7-34.0%), respectively. Individuals on antidepressants <10 months versus 10-12 months had higher risk of restarting antidepressants: the HR for antidepressant treatment <4 months was 1.21 (95% CI: 1.16-1.27), 4-6 months 1.11 (95% CI: 1.06-1.17), and 7-9 months 1.09 (95% CI: 1.04-1.15). Limitations: We were not able to ascertain the reasons why individuals discontinued antidepressants, and systematic errors from unmeasured confounders cannot be ruled out. Conclusions: Based on our findings, a minimum of 10-12 months of treatment appears to be preferable if there is concern about relapse after discontinuation.
@article{
title = {Discontinuation of antidepressants: Is there a minimum time on treatment that will reduce relapse risk?},
type = {article},
year = {2021},
pages = {254-260},
volume = {290},
websites = {https://doi.org/10.1016/j.jad.2021.04.045},
id = {77d500b2-32dc-335b-8ace-1853f7bb8476},
created = {2021-05-17T14:00:02.418Z},
accessed = {2021-05-17},
file_attached = {true},
profile_id = {031c901b-e377-3792-995f-e5d0201f5174},
last_modified = {2021-05-17T14:04:54.307Z},
read = {false},
starred = {false},
authored = {true},
confirmed = {false},
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abstract = {Background: Several national guidelines include recommendations for a minimum duration of antidepressant treatment, but these vary from 4-9 months after remission. We aimed to investigate whether there is an optimal minimum duration of antidepressant treatment to reduce relapse risk. Methods: A Danish population-based cohort study among 89,442 adults who initiated antidepressants for depression treatment aged 18-60 years, from 2006-2015. We defined antidepressant discontinuation as ≥30 days without treatment. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) to indicate the risk of restarting antidepressants among those who discontinued antidepressants with <4, 4-6, and 7-9 months of use compared with discontinuation after 10-12 months. Results: For individuals on antidepressant treatment <4, 4-6, 7-9 and 10-12 months, cumulative incidence of restarting treatment within one year was 37.4% (95% CI: 36.9-37.8%), 35.1% (95% CI: 34.6-35.7%), 35.0% (95% CI: 34.2-35.8%) and 32.8% (95% CI: 31.7-34.0%), respectively. Individuals on antidepressants <10 months versus 10-12 months had higher risk of restarting antidepressants: the HR for antidepressant treatment <4 months was 1.21 (95% CI: 1.16-1.27), 4-6 months 1.11 (95% CI: 1.06-1.17), and 7-9 months 1.09 (95% CI: 1.04-1.15). Limitations: We were not able to ascertain the reasons why individuals discontinued antidepressants, and systematic errors from unmeasured confounders cannot be ruled out. Conclusions: Based on our findings, a minimum of 10-12 months of treatment appears to be preferable if there is concern about relapse after discontinuation.},
bibtype = {article},
author = {Liu, Xiaoqin and Momen, Natalie C and Molenaar, Nina and Rommel, Anna-Sophie and Bergink, Veerle and Munk-Olsen, Trine},
doi = {10.1016/j.jad.2021.04.045},
journal = {Journal of Affective Disorders}
}
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We aimed to investigate whether there is an optimal minimum duration of antidepressant treatment to reduce relapse risk. Methods: A Danish population-based cohort study among 89,442 adults who initiated antidepressants for depression treatment aged 18-60 years, from 2006-2015. We defined antidepressant discontinuation as ≥30 days without treatment. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) to indicate the risk of restarting antidepressants among those who discontinued antidepressants with <4, 4-6, and 7-9 months of use compared with discontinuation after 10-12 months. Results: For individuals on antidepressant treatment <4, 4-6, 7-9 and 10-12 months, cumulative incidence of restarting treatment within one year was 37.4% (95% CI: 36.9-37.8%), 35.1% (95% CI: 34.6-35.7%), 35.0% (95% CI: 34.2-35.8%) and 32.8% (95% CI: 31.7-34.0%), respectively. Individuals on antidepressants <10 months versus 10-12 months had higher risk of restarting antidepressants: the HR for antidepressant treatment <4 months was 1.21 (95% CI: 1.16-1.27), 4-6 months 1.11 (95% CI: 1.06-1.17), and 7-9 months 1.09 (95% CI: 1.04-1.15). Limitations: We were not able to ascertain the reasons why individuals discontinued antidepressants, and systematic errors from unmeasured confounders cannot be ruled out. Conclusions: Based on our findings, a minimum of 10-12 months of treatment appears to be preferable if there is concern about relapse after discontinuation.","bibtype":"article","author":"Liu, Xiaoqin and Momen, Natalie C and Molenaar, Nina and Rommel, Anna-Sophie and Bergink, Veerle and Munk-Olsen, Trine","doi":"10.1016/j.jad.2021.04.045","journal":"Journal of Affective Disorders","bibtex":"@article{\n title = {Discontinuation of antidepressants: Is there a minimum time on treatment that will reduce relapse risk?},\n type = {article},\n year = {2021},\n pages = {254-260},\n volume = {290},\n websites = {https://doi.org/10.1016/j.jad.2021.04.045},\n id = {77d500b2-32dc-335b-8ace-1853f7bb8476},\n created = {2021-05-17T14:00:02.418Z},\n accessed = {2021-05-17},\n file_attached = {true},\n profile_id = {031c901b-e377-3792-995f-e5d0201f5174},\n last_modified = {2021-05-17T14:04:54.307Z},\n read = {false},\n starred = {false},\n authored = {true},\n confirmed = {false},\n hidden = {false},\n private_publication = {false},\n abstract = {Background: Several national guidelines include recommendations for a minimum duration of antidepressant treatment, but these vary from 4-9 months after remission. We aimed to investigate whether there is an optimal minimum duration of antidepressant treatment to reduce relapse risk. Methods: A Danish population-based cohort study among 89,442 adults who initiated antidepressants for depression treatment aged 18-60 years, from 2006-2015. We defined antidepressant discontinuation as ≥30 days without treatment. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) to indicate the risk of restarting antidepressants among those who discontinued antidepressants with <4, 4-6, and 7-9 months of use compared with discontinuation after 10-12 months. Results: For individuals on antidepressant treatment <4, 4-6, 7-9 and 10-12 months, cumulative incidence of restarting treatment within one year was 37.4% (95% CI: 36.9-37.8%), 35.1% (95% CI: 34.6-35.7%), 35.0% (95% CI: 34.2-35.8%) and 32.8% (95% CI: 31.7-34.0%), respectively. Individuals on antidepressants <10 months versus 10-12 months had higher risk of restarting antidepressants: the HR for antidepressant treatment <4 months was 1.21 (95% CI: 1.16-1.27), 4-6 months 1.11 (95% CI: 1.06-1.17), and 7-9 months 1.09 (95% CI: 1.04-1.15). Limitations: We were not able to ascertain the reasons why individuals discontinued antidepressants, and systematic errors from unmeasured confounders cannot be ruled out. 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