Internet and Telephone Support for Discontinuing Long-Term Antidepressants: The REDUCE Cluster Randomized Trial
ABSTRACT
There is concern about long-term antidepressant treatment, and this trial aimed to assess the safety and effectiveness of adding internet and telephone support to a family practitioner review for considering discontinuing long-term antidepressant treatment.
Participants were adults receiving antidepressants for more than 1 year for a first episode of depression or more than 2 years for recurrent depression, who were well enough to consider discontinuation and at low risk of relapse.
The intervention involved internet and telephone self-management support, and the primary outcome was depression at 6 months. Secondary outcomes included antidepressant discontinuation, anxiety, quality of life, antidepressant withdrawal symptoms, mental well-being, enablement, satisfaction, use of health care services, and adverse events.
The trial found that depression was slightly better with support, but the rate of antidepressant discontinuation did not significantly increase. However, improvements in antidepressant withdrawal symptoms and mental well-being were observed. The family practitioner review for discontinuation of antidepressants appeared safe and effective for over 40% of willing and well enough patients.
TRIAL REGISTRATION
ISRCTN registry Identifiers: ISRCTN15036829 (internal pilot trial) and ISRCTN12417565 (main trial).
PMID:38913372 | DOI:10.1001/jamanetworkopen.2024.18383
