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GPs could support almost half of patients to quit antidepressants, finds trial

GPs could support almost half of patients to quit antidepressants, finds trial

GPs could support almost half of patients taking long-term antidepressants – who are well and willing to stop – to safely come off the drugs, researchers have claimed.

The study, which was looking at the addition of a phone hotline or internet support to GP review in patients discontinuing antidepressants, found more than 40% safely stopped taking the drugs whichever approach was taken.

Those who could access online support and psychologists by phone had lower rates of depression, fewer withdrawal symptoms, and reported better mental wellbeing but the differences were small.

However, the additional support did tend to reduce calls on health services and therefore may be cost-effective at a population level, they reported.

The researchers from the Universities of Southampton, Hull and Liverpool said the trial of 330 participants across 131 GP practices around the country was the first to show that helping people stop taking antidepressants is possible at scale without providing resource-intensive psychological therapy.

After six months, 41.9% of patients in the control group who had support from their GP had successfully stopped taking the drugs compared with 45.5% of people in the group who also had access to internet or telephone helplines.

All those taking part did not currently have depression or were judged to not be at significant risk of relapse by their GP and wanted to discontinue treatment, the researchers reported in JAMA Network Open Psychiatry. They had been taking antidepressants for more than a year for a first instance of depression or more than two years for recurrence.

Roughly 15% of patients in each arm reported adverse events with one serious adverse reaction in each group, leading the researchers to conclude that discontinuation is safe to attempt in primary care, as long as patients are monitored for relapse and treatment can be quickly restarted.

Lead author Professor Tony Kendrick, professor of primary care at the University of Southampton, said the research showed high numbers of patients withdrawing from the drugs do not need costly intense therapy sessions.

‘This approach could eliminate the risk of serious side-effects for patients using antidepressants for long periods who have concerns about withdrawal.’

He added that offering patients internet and psychologist telephone support in addition to GP care was also cost-effective for the NHS.

‘Our findings show that support not only improves patient outcomes but also tends to reduce the burden on primary health care while people taper off antidepressants.’

Co-author Una Macleod, professor of primary care medicine at Hull York Medical School, said: ‘Many patients are taking antidepressants for depression for longer than two years, when they probably no longer need them.

‘The evidence in our study is clear and suggests the UK should establish a national helpline, by phone and online, to help people intending to come off the medication.’

Professor of general practice Mark Gabbay, a co-author from the University of Liverpool, added: ‘This is the first study to demonstrate that stopping inappropriate long-term antidepressant treatment is possible at scale without psychological therapy.

‘From our findings, we are calling for active family practitioner reviews for antidepressant discontinuation to be promoted.’

It follows a study last month which showed only one in six people who stop taking antidepressants will experience withdrawal symptoms as a direct result, a much lower proportion than other studies have suggested.

Around one in 35 people (3%) will likely experience ‘severe symptoms’, the study in the Lancet Psychiatry also found. 


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Not on your Nelly 27 June, 2024 5:39 pm

That would be great with unlimited time, money and resources…..BUT….

Yes Man 28 June, 2024 7:05 am

Let PAs do it.

David Church 28 June, 2024 7:21 pm

How could they justify using Psychologists to get well people to stop taking unecessary medication when it appears to take years to get a Psychologist to see a patient who is desperately in need of one?

Waseem Jerjes 30 June, 2024 4:18 pm

GPs have a crucial role in helping patients on long-term antidepressants safely discontinue their use. It’s encouraging to see that with proper support, nearly half of these patients can stop taking the medication without significant issues. Establishing a national helpline for additional support would be a wise investment, improving patient outcomes and reducing strain on healthcare services.

Jude the Obscure 1 July, 2024 9:33 am

How long was the follow up? Absolutely in favour of stopping “unnecessary” medication but very suspicious of single issue agenda driven medicine. Start with an assumption (too many people are on antidepressants) get your study to support your solution. Bingo! Yes then tell the politicians wheel in the PAs to enact your ‘policy’ on a national scale. Think of all the money you’ll save. The same was done in the treatment of opiate addiction. The assumption “Too many people are on methadone!”. The solution: people recover. Implementation: care is now time limited, you don’t need long term support (nobody does) you will all recover. And we’ll stop Drs prescribing too (no need because now we have the solution) – we’ll just give our new treatment protocol to nurse prescribers. Result: 10 years later: lots of people who didn’t recover are dead. What a drug bill saving. Thank you Russel Brand. I could expand sideways and inversely to HRT but I wont. Beware of single issue agenda driven medicine

Finola ONeill 2 July, 2024 11:35 am

yes; it’s the old ‘there are lies, damn lies and then there are statistics’.
You can make research and number show pretty much whatever you want so long as you select the criteria to support your theory/outcome.
It’s why clinical experience is so important and why NHSE/government should fund us and then back off and leave us to do our job.
But that pretty much cuts out their role of micro managing us and managers and politicians have never decided professionals would be best funded and left alone (teachers, local councils, etc).
And so the targets, management expansions, ‘data solutions’ and de professionalising professions continues.
Go figure