Reduced risk of relapse found with long-term antidepressants

Staying on long-term antidepressants reduces risk of relapse, according to a new study.

When people stopped taking antidepressants after a long period of use in the trial, just over half (56%) experienced a relapse within a year. This compared to 39% of those who stayed on medication.

Southampton researchers contributed to the study, led by UCL, which has published its findings in The New England Journal of Medicine.

Researchers hope the new insight can help doctors and patients to make informed decisions on whether to stop antidepressants after recovery from a depressive episode.

Rising rates for antidepressants

Prescriptions of antidepressants have increased dramatically over recent decades. There remains limited knowledge whether the treatment remains effective over many years.

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

Half of the study participants stopped taking their medication and half continued. Those who stopped their antidepressants were given reduced dosages for up to two months, before receiving placebo pills only.

Lead author Dr Gemma Lewis, of UCL Psychiatry, says: “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.”

New evidence for long-term treatment

Of the 56% who experienced relapse after stopping antidepressants in the trial, only half then chose to return to a medicine prescribed by their clinician.

Tony Kendrick, Professor of Primary Care at the University of Southampton who was part of the study team, adds: “It is reasonable to try to stop long-term antidepressants while monitoring for relapse, as they can be successfully restarted if depression returns.”

The research team recommends that all patients who are unsure about what to do next should talk to their doctor.

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