David Taylor says this about the NEJM study: "This study shows that discontinuing antidepressants in long term users leads to a greater risk of relapse than that seen in people continuing their medication. It seems to suggest that antidepressants are effective at (1/n)
preventing relapse. However, the speed and nature of antidepressant discontinuation is known to have a major effect on risk of relapse and this alone might explain the differences observed ..2/n
- patients were withdrawn over two months using a coarse linear dose reduction schedule which included alternate day dosing (even with short-acting drugs). ..3/n
It is also possible that the use of antidepressants itself sensitises people to future episodes of depression. 4/n
The overall conclusion is that people taking antidepressants for more than two years and who are well have a >50% chance of relapse if the antidepressant is withdrawn over two months using alternate day dosing. 5/n
Longer, hyperbolic and more individualised withdrawal regimens might reduce the risk of relapse." 6/n
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