Discontinuation of antidepressants after remission with antidepressant medication in major depressive disorder: a systematic review and meta-analysis

A significant clinical issue encountered after a successful acute major depressive disorder (MDD) treatment is the relapse of depressive symptoms. Although continuing maintenance therapy with antidepressants is generally recommended, there is no established protocol on whether or not it is necessary...

Full description

Saved in:
Bibliographic Details
Published in:Molecular psychiatry 2021-01, Vol.26 (1), p.118-133
Main Authors: Kato, Masaki, Hori, Hikaru, Inoue, Takeshi, Iga, Junichi, Iwata, Masaaki, Inagaki, Takahiko, Shinohara, Kiyomi, Imai, Hissei, Murata, Atsunobu, Mishima, Kazuo, Tajika, Aran
Format: Article
Language:English
Subjects:
692/53/2422
692/699/476/1414
Antidepressants
Antidepressive Agents - administration & dosage
Antidepressive Agents - therapeutic use
Antidepressive Agents, Tricyclic - administration & dosage
Antidepressive Agents, Tricyclic - therapeutic use
Behavioral Sciences
Biological Psychology
Clinical significance
Controlled Clinical Trials as Topic
Depression - drug therapy
Depressive Disorder, Major - drug therapy
Drug therapy
Humans
Major depressive disorder
Medicine
Medicine & Public Health
Mental depression
Meta-analysis
Neurosciences
Patient outcomes
Pharmacotherapy
Placebos
Psychiatry
Regression (Disease)
Remission
Remission (Medicine)
Remission Induction
Review
Review Article
Selective Serotonin Reuptake Inhibitors - administration & dosage
Selective Serotonin Reuptake Inhibitors - therapeutic use
Systematic review
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A significant clinical issue encountered after a successful acute major depressive disorder (MDD) treatment is the relapse of depressive symptoms. Although continuing maintenance therapy with antidepressants is generally recommended, there is no established protocol on whether or not it is necessary to prescribe the antidepressant used to achieve remission. In this meta-analysis, the risk of relapse and treatment failure when either continuing with the same drug used to achieved remission or switching to a placebo was assessed in several clinically significant subgroups. The pooled odds ratio (OR) (±95% confidence intervals (CI)) was calculated using a random effects model. Across 40 studies ( n  = 8890), the relapse rate was significantly lower in the antidepressant group than the placebo group by about 20% (OR = 0.38, CI: 0.33–0.43, p  
ISSN:1359-4184
1476-5578
DOI:10.1038/s41380-020-0843-0