Maintaining or Discontinuing Antidepressants in Primary Care
Depression is a common mental disorder that causes a person to experience a depressed mood, loss of interest and pleasure, and feelings of helplessness that can persist for very long periods of time. Strikingly, depression among adults in the United States has nearly tripled since the COVID-19 pandemic started in 2020 and rates of depression continue to remain at the same elevated level. Given the high prevalence of depression, many scientific studies are focusing on the development and progression of treatment methods.
Of the many avenues for treating depression, the prescription of antidepressants is one of the most prevailing methods used today due to its accessibility and mainstream acceptance. Essentially, antidepressants increase the amount of chemicals in the brain called neurotransmitters, which can have mood-increasing effects and help combat depressive episodes. However, antidepressants can have severe side effects if not taken with caution — addiction to and abuse of antidepressants is not uncommon, and users can experience withdrawal symptoms if they suddenly stop taking the medication.
An abundance of research is being performed on the consequences of using and discontinuing antidepressants. One study in particular examined the effects of coming off antidepressants during the maintenance phase of treatment. The maintenance phase describes the long-term usage of antidepressants after depressive symptoms have decreased — its goal is to prevent the recurrence of another depressive episode. While much of the previous research focused on persons who utilized antidepressants for shorter periods of less than eight months, this study analyzed the more long-term maintenance phase.
The study recruited individuals who were not currently experiencing a depressive episode, had been taking antidepressants for over nine months, and were willing to stop taking their medication. They then separated participants into groups: the maintenance group would continue taking antidepressants, and the discontinuation group would unknowingly take placebo pills instead of their usual medication. Over the course of one year, the study monitored whether the participants relapsed — experienced a recurrence of a depressive episode — or not.
Of the many avenues for treating depression, the prescription of antidepressants is one of the most prevailing methods used today due to its accessibility and mainstream acceptance. Essentially, antidepressants increase the amount of chemicals in the brain called neurotransmitters, which can have mood-increasing effects and help combat depressive episodes. However, antidepressants can have severe side effects if not taken with caution — addiction to and abuse of antidepressants is not uncommon, and users can experience withdrawal symptoms if they suddenly stop taking the medication.
An abundance of research is being performed on the consequences of using and discontinuing antidepressants. One study in particular examined the effects of coming off antidepressants during the maintenance phase of treatment. The maintenance phase describes the long-term usage of antidepressants after depressive symptoms have decreased — its goal is to prevent the recurrence of another depressive episode. While much of the previous research focused on persons who utilized antidepressants for shorter periods of less than eight months, this study analyzed the more long-term maintenance phase.
The study recruited individuals who were not currently experiencing a depressive episode, had been taking antidepressants for over nine months, and were willing to stop taking their medication. They then separated participants into groups: the maintenance group would continue taking antidepressants, and the discontinuation group would unknowingly take placebo pills instead of their usual medication. Over the course of one year, the study monitored whether the participants relapsed — experienced a recurrence of a depressive episode — or not.
Discontinuing antidepressants could lead to a higher chance of relapse.
Image Source: christopher lemercier
The results showed a higher rate of relapse in the discontinuation group than the maintenance group: 59% of participants in the discontinuation group relapsed, while only 39% did in the maintenance group. Moreover, the maintenance group, on average, scored worse than the discontinuation group on assessments for overall mental health-related quality of life, including levels of anxiety and depression. Finally, a greater percentage of the participants in the discontinuation group (48%) stopped taking the trial medication before the end of the study compared to the maintenance group (30%).
This study showed that in the long-term maintenance phase of treatment, the discontinuation of antidepressants could be related to higher rates of relapse. Moreover, participants who discontinued their antidepressants were more likely to have worse overall mental health than those who maintained them, and more participants in the discontinuation group felt they were unable to continue with the trial. These findings suggest that the participants were dependent on antidepressants even when not experiencing a depressive episode, illustrating the long-term consequences of taking these medications.
Although antidepressants are certainly effective and beneficial in the treatment of depression, they aren’t without short and long-term effects. As this study has shown, the discontinuation of antidepressants is shown to be linked to a higher chance of relapse, which is something that must be considered when taking depression medication. With the prominence of depression in contemporary society, it is important to have an understanding of its attributes and treatments.
This study showed that in the long-term maintenance phase of treatment, the discontinuation of antidepressants could be related to higher rates of relapse. Moreover, participants who discontinued their antidepressants were more likely to have worse overall mental health than those who maintained them, and more participants in the discontinuation group felt they were unable to continue with the trial. These findings suggest that the participants were dependent on antidepressants even when not experiencing a depressive episode, illustrating the long-term consequences of taking these medications.
Although antidepressants are certainly effective and beneficial in the treatment of depression, they aren’t without short and long-term effects. As this study has shown, the discontinuation of antidepressants is shown to be linked to a higher chance of relapse, which is something that must be considered when taking depression medication. With the prominence of depression in contemporary society, it is important to have an understanding of its attributes and treatments.
Featured Image: Christina Victoria Craft
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