Wednesday, June 26, 2024

GP monitoring of those on antidepressants

Tony Kendrick, who I have mentioned before (see eg. previous post) is the first author of a paper about antidepressant withdrawal in general practice. It found that more than 40% of patients could discontinue their antidepressant treatment in a clinical trial, comparing whether adding internet and telephone support to family practitioner review was more effective than practitioner review alone. The numbers that managed to withdraw under the two conditions was not significantly different, although those that had added support had small improvements in depression, antidepressant withdrawal symptoms and mental well-being.

However, only 4.9% of patients who were mailed invitations were eligible and consented to the trial. They had to be well enough to consider discontinuation, wish to do so and be at low risk of relapse. As I said in a previous post, people are generally very reluctant to take part in antidepressant discontinuation trials. There is at least a question about how much the results of the trial are generalisable to all those on antidepressants. Antidepressant discontinuation problems should not be minimised (see eg. last post). 

Nonetheless, if the paper leads to more review by general practitioners of those taking maintenance antidepressants this should be welcomed. Doctors are making far too many patients dependent on antidepressants and need to do more to prevent this happening (see eg. another previous post).

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