Impact of duration of antidepressant treatment on the risk of occurrence of a new sequence of antidepressant treatment

Pharmacopsychiatry. 2011 May;44(3):96-101. doi: 10.1055/s-0031-1271686. Epub 2011 Feb 16.

Abstract

Introduction: Despite the recommendation that antidepressant treatment should be continued for several months to reduce the risk of relapse/recurrence of depression, early discontinuation is frequent in naturalistic conditions. The study was aimed at exploring the impact of early discontinuation of antidepressant treatment on the risk of antidepressant re-initiation.

Methods: A follow-up study of persons (n=35,053) starting antidepressant treatment was performed using a representative sample of the French Social Security Insurance national database.

Results: The risk of re-initiation of antidepressant treatment was higher if the duration of the index episode of antidepressant treatment was ≥ 6 months [hazard ratio (HR)=2.35; 95% CI 2.25-2.45) or 2-5 months (HR=1.65; 95% CI 1.59-1.71) compared to ≤ 1 month. The other characteristics independently associated with re-initiation of treatment were older age, female gender, low income, serious chronic illness, index prescription by a specialist and co-prescription of other psychotropic drugs.

Conclusions: The lower risk of re-initiation of antidepressant treatment in persons with shorter-than-recommended duration of antidepressant treatment might be explained by overprescription of antidepressants in persons with sub-threshold symptoms.

MeSH terms

  • Adult
  • Aged
  • Aging
  • Antidepressive Agents / therapeutic use*
  • Chronic Disease
  • Databases, Factual
  • Depression / drug therapy*
  • Depressive Disorder / drug therapy*
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Psychotropic Drugs / therapeutic use*
  • Recurrence
  • Risk
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Antidepressive Agents
  • Psychotropic Drugs