Long-term use of antidepressant medications helps reduce the risk of relapse for people who suffer from recurrent depression, according to new research.
In what is the first study of its kind by scientists from University College London, 56 percent of people who stopped taking antidepressants became depressed again within 12 months, after years of use.
By comparison, only 39 percent of people who continued taking their medication during the same one-year period experienced a depressive relapse, the research found.
The number of antidepressants delivered by GPs in England has increased in recent years, from 30 million in 2005 to 61 million in 2015, to 76 million in 2020.
This is because of the increase in the time for which people are taking their medicine. More than 1.5 million individuals in England have been on antidepressants for two years or more.
Evidence for the long-term benefits of antidepressants has been limited in recent years. “Until now we didn’t know if antidepressant treatment was still effective when someone had been taking them for many years,” said study lead author Dr. Gemma Lewis, lecturer in the Mental Health Study at UCL.
“We have found that staying on antidepressants for a long time can effectively reduce the risk of relapse.”
research, published in New England Journal of Medicine, included 478 patients who were taking antidepressants for a long time and experiencing at least two or more episodes of depression. Some 70 percent had been taking the drug for more than three years.
In a randomized, double-blind controlled trial, half of the study participants stopped taking their medication and half continued. Those who discontinued their antidepressants were given low doses for up to two months as part of a tapering regime, before being given only placebo pills.
The following year, 56 percent of participants stopped taking their antidepressants, while 39 percent of participants continued to take them.
Of the 56 percent who experienced relapse after discontinuing, only half decided to return to the antidepressant prescribed by their doctor. Researchers say some relapses, as well as potential withdrawal symptoms, may not be severe enough for a person to decide they need to go back on their medication.
Research has shown that people who discontinued their antidepressants were more likely to experience withdrawal symptoms. Despite this, by the end of the study, 59 percent of the discontinuation group were not taking antidepressants.
“Many people can go off their medication without stopping, although at present we cannot identify who those people are,” Dr. Lewis said.
The study showed that 44 percent of those in the discontinuation group did not relapse during the trial, while 61 percent continued to receive the drug.
“The research question here may be really figuring out which people are benefiting and which are not,” said Glynn Lewis, professor of epidemiological psychiatry at UCL.
“We’re working with an average. We want to be able to identify those people, the 40 percent who can go off their antidepressants without relapse. But at the moment we can’t identify those people.”
Co-lead author Dr Louise Marston, from the UCL Institute of Epidemiology and Health Care, said: “We don’t yet know why some people are able to wean off their antidepressants and some can’t, so further research should help us This may help predict who can safely stop antidepressants.”
The scientists said combining antidepressants with cognitive behavioral and mindfulness-based therapies would make some people more likely to benefit from a dual approach.
Prof Lewis said that “antidepressants are effective, but like many drugs, are not ideal for everyone”, highlighting that 39 percent of people who continued their treatment still experienced a relapse. His colleagues cautioned that the drugs “do not guarantee well-being”.
Credit: www.independent.co.uk /