Cited by 92Treatment of Major DepressionMental Health Treatment and AccessAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

The DOI matches its Crossref record; 277 of the 293 references it cites were found in a registry or an index; 79 of the 228 sources its claims cite were checked for support.

Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults

Open access

Van Leeuwen, Ellen, van Driel, Mieke L, Horowitz, Mark A, Kendrick, Tony, Donald, Maria, De Sutter, An IM, Robertson, Lindsay, Christiaens, Thierry·2021·Cochrane Database of Systematic Reviews

DOI 10.1002/14651858.cd013495.pub2PMC PMC8092632

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Abstract

EDITORIAL NOTE: This editorial note has been published by the editors of Cochrane to alert readers that the following study included in this systematic review has an associated retraction. Associated studies with retractions of one or more study reports: Hollon SD, DeRubeis RJ, Fawcett J, Amsterdam JD, Shelton RC, Zajecka J, et al. Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomised clinical trial. JAMA Psychiatry. 2014;71(10):1157–64. An assessment into the impact of removing this study on the review’s findings and conclusions is currently underway. Further editorial updates will be provided once this assessment is complete. BACKGROUND: Depression and anxiety are the most frequent indication for which antidepressants are prescribed. Long-term antidepressant use is driving much of the internationally observed rise in antidepressant consumption. Surveys of antidepressant users suggest that 30% to 50% of long-term antidepressant prescriptions had no evidence-based indication. Unnecessary use of antidepressants puts people at risk of adverse events. However, high-certainty evidence is lacking regarding the effectiveness and safety of approaches to discontinuing long-term antidepressants. OBJECTIVES: To assess the effectiveness and safety of approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults. SEARCH METHODS: We searched all databases for randomised controlled trials (RCTs) until January 2020. SELECTION CRITERIA: We included RCTs comparing approaches to discontinuation with continuation of antidepressants (or usual care) for people with depression or anxiety who are prescribed antidepressants for at least six months. Interventions included discontinuation alone (abrupt or taper), discontinuation with psychological therapy support, and discontinuation with minimal intervention. Primary outcomes were successful discontinuation rate, relapse (as defined by authors of the original study), withdrawal symptoms, and adverse events. Secondary outcomes were depressive symptoms, anxiety symptoms, quality of life, social and occupational functioning, and severity of illness. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures as expected by Cochrane. MAIN RESULTS: We included 33 studies involving 4995 participants. Nearly all studies were conducted in a specialist mental healthcare service and included participants with recurrent depression (i.e. two or more episodes of depression prior to discontinuation). All included trials were at high risk of bias. The main limitation of the review is bias due to confounding withdrawal symptoms with symptoms of relapse of depression. Withdrawal symptoms (such as low mood, dizziness) may have an effect on almost every outcome including adverse events, quality of life, social functioning, and severity of illness. Abrupt discontinuation Thirteen studies reported abrupt discontinuation of antidepressant. Very low-certainty evidence suggests that abrupt discontinuation without psychological support may increase risk of relapse (hazard ratio (HR) 2.09, 95% confidence interval (CI) 1.59 to 2.74; 1373 participants, 10 studies) and there is insufficient evidence of its effect on adverse events (odds ratio (OR) 1.11, 95% CI 0.62 to 1.99; 1012 participants, 7 studies; I² = 37%) compared to continuation of antidepressants, without specific assessment of withdrawal symptoms. Evidence about the effects of abrupt discontinuation on withdrawal symptoms (1 study) is very uncertain. None of these studies included successful discontinuation rate as a primary endpoint. Discontinuation by "taper" Eighteen studies examined discontinuation by "tapering" (one week or longer). Most tapering regimens lasted four weeks or less. Very low-certainty evidence suggests that "tapered" discontinuation may lead to higher risk of relapse (HR 2.97, 95% CI 2.24 to 3.93; 1546 participants, 13 studies) with no or little difference in adverse events (OR 1.06, 95% CI 0.82 to 1.38; 1479 participants, 7 studies; I² = 0%) compared to continuation of antidepressants, without specific assessment of withdrawal symptoms. Evidence about the effects of discontinuation on withdrawal symptoms (1 study) is very uncertain. Discontinuation with psychological support Four studies reported discontinuation with psychological support. Very low-certainty evidence suggests that initiation of preventive cognitive therapy (PCT), or MBCT, combined with "tapering" may result in successful discontinuation rates of 40% to 75% in the discontinuation group (690 participants, 3 studies). Data from control groups in these studies were requested but are not yet available. Low-certainty evidence suggests that discontinuation combined with psychological intervention may result in no or little effect on relapse (HR 0.89, 95% CI 0.66 to 1.19; 690 participants, 3 s

Integrity signals

Registry

Crossref · 10.1002/14651858.cd013495.pub2

Cites

277 of 279 references verified2 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

79 of 228 cited sources checked · 33 supported · 2 flagged · accuracy not yet measured

At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“16 of 85 (split 8/43) (19%) were able to reduce the dose by a minimum of 50%.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.1 Successful discontinuation rate
What the sources say
- Disputed
  In the Results baseline table (page unavailable), 16/85 (19%) refers to participants receiving current psychological or psychotherapeutic treatment, not to antidepressant dose reduction. The Statistical analysis section defines a 50% dose reduction for a per-protocol analysis, but does not report 8/43 or 16/85 as achieving it. (LLM, conf=0.86)
  Checked by a reasoning model — may be wrong.
  cites Bockting 2018 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“randomised studies with a tapering period up to 14 days showed either no or minimal reduction in withdrawal symptom severity compared with abrupt discontinuation (Baldwin 2006;Bogetto 2002;Montgomery 2004a).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Disputed
  The Tolerability assessments section describes a randomized comparison of stopping treatment immediately versus continuing the same dose for one more week before stopping—not tapering versus abrupt discontinuation. The DESS results section says the dose-reduction group had no randomized withdrawal comparison and omits its results from the figure. This paper therefore does not show that tapering reduced withdrawal symptoms minimally or not at all compared with abrupt discontinuation. (LLM, conf=0.86)
  Checked by a reasoning model — may be wrong.
  cites Baldwin 2006 sourceExperimental — accuracy not yet measured
- Not checked — no full text of the sourcecites Bogetto 2002 source
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Montgomery 2004a
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“although none of the trials on which this conclusion was based measured withdrawal effects (Cohen 2019;Hengartner 2020;Recalt 2019)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Continuation and maintenance treatment
What the sources say
- Not checked — no full text of the sourcecites Cohen 2019 source
- Partly supported
  The ‘Withdrawal confounding in relapse prevention trials’ section says that symptom scales used to assess relapse cannot distinguish withdrawal symptoms from depression relapse. The ‘Summary and conclusion’ likewise says withdrawal confounding makes the trials difficult to interpret. Neither passage establishes the stronger claim that none of the trials measured withdrawal effects. (LLM, conf=0.82)
  cites Hengartner 2020 sourceExperimental — accuracy not yet measured
- Not checked — no full text of the sourcecites Recalt 2019 source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Every source the paper cites for this claim was checked and supports it.
In the paper
“Antidepressant treatment duration of up to one year results in lower relapse rates among responders compared with treatment discontinuation in anxiety disorders, irrespective of the type of anxiety disorder (Batelaan 2017).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Anxiety disorders
What the sources say
- Supported
  The Discussion’s ‘What this study adds’ section reports a clear benefit of continuing antidepressants for up to one year in patients with remitted anxiety disorders and says relapse risk was not significantly influenced by anxiety disorder type. The abstract likewise reports higher relapse rates among responders who discontinued treatment than among those who continued it during up to one year of follow-up. (LLM, conf=0.93)
  cites Batelaan 2017 source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“For stable remitters (all HAM-D scores ≥ 7 during remission), there were no differences in relapse of absence of withdrawal symptoms measured a er antidepressants were tapered (relapse rates: 50% discontinuation group, 59% antidepressant group; HR not reported; P = 0.49).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.1.2 Studies that could not be pooled
What the sources say
- Partly supported
  The Relapse section reports 50% relapse with placebo after antidepressant taper versus 59% with maintenance antidepressants among stable remitters, with P=.49 for that comparison. However, the Study Phases section defines stable remission as HRSD scores ≤7, not ≥7 as the citing sentence states. The cited passages also do not establish the sentence’s suggestion about withdrawal symptoms. (LLM, conf=0.90)
  cites Segal 2010 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Wilson 2003 (n = 113) reported that 2 of 57 (3.5%) participants in remission of a first depression in the discontinuation group experienced adverse events that necessitated discontinuation compared to 2 of 56 (3.6%) participants treated with antidepressants.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.4.2 Studies with other outcome measures
What the sources say
- Partly supported
  The Study sample section reports 56 participants assigned to sertraline and 57 to placebo, matching the claim’s group sizes. However, the passages in our copy do not report two adverse-event-related discontinuations in either group; searches for adverse events and reasons for withdrawal did not establish those counts. (LLM, conf=0.78)
  cites Wilson 2003 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibratedn = 113
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Among unstable remitters (one or more with HAM-D score ≥ 7 during remission), participants in the discontinuation group showed higher risk of relapse compared with those in the continuation group (relapse rates: discontinuation group 71%, 27% antidepressant; HR 4.16, 95% CI 1.12 to 14.3; P = 0.03).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.1.2 Studies that could not be pooled
What the sources say
- Partly supported
  The Relapse section reports adjusted relapse rates of 71% for placebo (antidepressant discontinuation) and 27% for maintenance antidepressants among unstable remitters, with P=.03. Its hazard ratio is expressed in the opposite direction: 0.24 (95% CI 0.07–0.89) for maintenance antidepressants versus placebo, approximately 4.16 (1.12–14.3) when inverted. The Study Phases section defines unstable remission by occasional elevated HRSD scores of 8–14, not by a score of ≥7, as the citing sentence states. Page numbers are unavailable in our copy. (LLM, conf=0.88)
  cites Segal 2010 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Bockting 2018 reported that 34 of 85 (split to allow multiple-arm comparisons: 17/43) (40%) participants in the discontinuation with PCT group followed the discontinuation advice and discontinued their antidepressant a er six months”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.1 Successful discontinuation rate
What the sources say
- Partly supported
  The Results (page unavailable) identify 85 participants assigned to PCT while tapering antidepressants, supporting the group size. They report that 30 of 50 participants still in the study after six months adhered to the antidepressant protocol, but do not report that 34 of 85 discontinued antidepressants or establish the citing paper’s split figure of 17/43. (LLM, conf=0.82)
  cites Bockting 2018 sourceExperimental — accuracy not yet measured
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Huijbers 2016 reported no differences between groups on six scales (World Health Organization (WHO) Quality of Life overall perception, Q1 and Q2, and WHO Quality of Life emotional, physical, psychological, and environmental domains) a er 15 months of follow-up (see Table 2).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.7.2 Quality of life measured by other scales
What the sources say
- Partly supported
  The Results (Secondary outcomes; page unavailable) report no between-group differences in quality of life at 15 months, supporting the main finding. Our copy does not identify the six named scales or report their results separately, so that level of specificity is not verified. (LLM, conf=0.82)
  cites Huijbers 2016 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
Every source the paper cites for this claim was checked and supports it.
In the paper
“In all, 162 of 212 (76%) participants in the continuation group remained on the therapeutic dose and 50 (24%) did not remain on the therapeutic dose.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.1 Successful discontinuation rate
What the sources say
- Supported
  The Results (Table 2, adherence to treatment) report that 162 (76%) participants in the maintenance antidepressant group remained on a therapeutic dose and 50 (24%) did not. The Results also state that 212 participants were allocated to that group. (LLM, conf=0.95)
  cites Kuyken 2015 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes

Show all 307 claims

It may state two separate claims as one. 166
Probably not a substantial claim. 239
The quote only partly states this claim. 16

Every source the paper cites for this claim was checked and supports it.
In the paper
“Antidepressant withdrawal reactions are widespread.A recent review suggests incidence rates from 27% to 86%, with an average incidence of 56%, and with up to half of those experiencing withdrawal symptoms having severe reactions (Davies 2019).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Long-term antidepressant use
What the sources say
- Supported
  The Incidence section reports rates of 27%–86% across 14 studies and a weighted average of 55.7%, which rounds to 56%. The Severity section reports that 43%–51% of people experiencing withdrawal selected the most extreme severity level in four surveys, supporting the description that up to half had severe reactions. (LLM, conf=0.94)
  cites Davies 2019 source
Strength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Evidence is lacking regarding strategies for discontinuation of antidepressants, and the optimal method of stopping antidepressants is currently unknown; however slow enough tapering can make withdrawal symptoms tolerable (Horowitz 2019).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Description of the intervention
What the sources say
- Partly supported
  The Future directions for research section says robust evidence to guide tapering is lacking and that the proposed approach needs confirmation in randomized trials. The paper also says slow tapering can limit withdrawal symptoms to tolerable severity. Its analysis and proposed method focus on SSRIs, however, so the claim extends its conclusions to antidepressants generally. (LLM, conf=0.82)
  cites Horowitz 2019 sourceExperimental — accuracy not yet measured
Load-bearingStrength:plain· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“We assessed two studies as having high of bias; in one study, authors reported possible bias due to absence of independent raters (Kocsis 1996); in the other study, authors reported that it was impossible to keep research assistants at different sites masked to intervention group because they were involved in the practical organisation of the trial (Huijbers 2016).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Detection bias (blinding of outcome assessment)
What the sources say
- Not checked — no full text of the sourcecites Kocsis 1996 source
- Supported
  Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
  cites Huijbers 2016 source
Strength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Antidepressants have been associated with withdrawal symptoms since 1960 for TCAs and MAOs (Nilsen 2012), and since the 1990s for SSRIs and SNRIs (Fava 2015; Fava 2018b).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Selective reporting
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Nilsen 2012
- Partly supported
  The Introduction says case reports began documenting SSRI withdrawal reactions in the 1990s. The Multiple Drug Comparisons section also reports withdrawal symptoms with venlafaxine XR, an SNRI, but does not establish that SNRI withdrawal was documented in the 1990s. The TCA/MAOI portion is attributed to a different citation and is not assessed here; page numbers were not supplied for these passages. (LLM, conf=0.86)
  cites Fava 2015 sourceExperimental — accuracy not yet measured
- Supported
  The 2018 citation is offered alongside a separate SSRI review, so its relevant part is the claim about SNRIs. The Results (p. 5) identify venlafaxine withdrawal case reports, and the paper’s reference list (p. 9) dates reports of venlafaxine withdrawal to 1996, supporting an association since the 1990s. (LLM, conf=0.90)
  cites Fava 2018b source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Study authors reported a significant difference in discontinuation, favouring the discontinuation group (Van Leeuwen 2020c [pers comm]): 17 of 128 (13%) in the discontinuation group reduced the dose of antidepressant and 17 of 121 (14%) in the antidepressant group.Study authors reported no difference in adherence to the allocated intervention (chi = 3.30; P = 0.07).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.1.1 All studies
What the sources say
- Partly supported
  The Results section ('Patient characteristics, flow and adherence'; page unavailable) reports no statistically significant difference in adherence to the medication regimens (χ² = 3.30, P = 0.07), as claimed. It does not support a significant difference in discontinuation favouring the discontinuation group: 53% adhered to discontinuation versus 64% to continuation, and the cited 17-of-128 and 17-of-121 figures are not reported in the passages found. (LLM, conf=0.90)
  cites Huijbers 2016 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In the discontinuation group (n = 128), 68 of 128 (53%) discontinued antidepressant within six months a er baseline and 2 of 128 (2%) additional participants discontinued a er six months compared to 14 of 121 (12%) in the continuation group who discontinued antidepressant during the 15-month follow-up.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.1.1 All studies
What the sources say
- Partly supported
  The Results section (‘Patient characteristics, flow and adherence’; page unavailable) reports that 68/128 (53%) adhered to the discontinuation regimen and identifies the continuation group as n=121. It does not report that the 68 discontinued within six months, that another 2/128 discontinued later, or that 14/121 discontinued during the 15-month follow-up. (LLM, conf=0.86)
  cites Huijbers 2016 sourceExperimental — accuracy not yet measured
Load-bearingStrength:plain· not yet calibratedn = 128
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“This study reported that 17 of 42 (40%) participants in the discontinuation group discontinued the antidepressant a er six months and 8 of 42 participants (19%) were able to reduce the dose by a minimum of 50%.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.1.1 All studies
What the sources say
- Could not verify
  The Results report six-month protocol adherence as 30 of 50 participants in the PCT-with-tapering group, not the claimed discontinuation and dose-reduction figures. The Statistical analysis section uses a 50% dose reduction within six months as a per-protocol criterion, but our copy does not report 17/42 discontinuing or 8/42 reducing their dose; searches for both fractions and percentages found no matching passage. No page numbers were available in the indexed passages. (LLM, conf=0.75)
  cites Bockting 2018 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibratedn = 42
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Bockting 2018 (n = 146) recorded serious adverse events and reported one suicide attempt in the tapering group; one participant in the continuation with PCT group died.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.3 Studies that could not be pooled
What the sources say
- Supported
  The Results report one suicide attempt in the PCT-with-tapering group and one death in the PCT-and-antidepressants group during 24 months of follow-up. The paper also reports a second suicide attempt in the antidepressants-alone group, which does not conflict with the claim. (LLM, conf=0.94)
  cites Bockting 2018 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Kuyken 2015 reported that 124 of 212 (59%) discontinued the antidepressant”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.1 Successful discontinuation rate
What the sources say
- Partly supported
  Table 2 (Results; page not available in our copy) reports that 124 participants discontinued antidepressants, but its denominator is the 176 MBCT-TS participants who attended at least four sessions: 124/176 (71%). The trial allocated 212 participants to MBCT-TS, making 124/212 approximately 59%, but the paper does not report that as its discontinuation rate or specify that the 124 discontinued at 24 months. (LLM, conf=0.86)
  cites Kuyken 2015 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
The quote only partly states this claim.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“They reported two suicide attempts (one in the PCT with tapering of antidepressants group, and one in the antidepressants only group).Study authors reported no indication that these were Cochrane Database of Systematic Reviews related to the interventions.They reported no deaths in both groups.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.4 Adverse events
What the sources say
- Partly supported
  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
  cites Bockting 2018 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibratedn = 185
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Kuyken 2015 (n = 424) reported three non-fatal and two fatal serious adverse events (deaths) in each treatment group; these were considered probably not related to the intervention or the trial.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.4 Adverse events
What the sources say
- Supported
  Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
  cites Kuyken 2015 source
Strength:plain· not yet calibratedn = 424
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Neither of these studies measured withdrawal symptoms nor made adjustments for withdrawal symptoms.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > See Analysis 3.2.
What the sources say
- Not checked — no full text of the sourcecites Kuyken 2008 source
- Partly supported
  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
  cites Kuyken 2015 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✗ Asserted: fails✓ Checkable: passes✗ Load-bearing: fails✗ Based: fails
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Neither of these studies measured withdrawal symptoms nor made adjustments for withdrawal symptoms.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > See Analysis 3.2.
What the sources say
- Not checked — no full text of the sourcecites Kuyken 2008 source
- Supported
  The Outcomes section lists the measures collected at follow-up, including GRID-HAMD depressive-symptom scores, but does not list a withdrawal-symptom measure. The Table 4 note says the analyses were adjusted for baseline depression severity and centre, not withdrawal symptoms. These passages support the statement for the PREVENT trial; this source cannot establish what the other study measured. (LLM, conf=0.86)
  cites Kuyken 2015 source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Bockting 2018 (n = 185; split 143) reported two suicide attempts (one in the discontinuation with PCT group, and one in the continuation group) during the 104-week follow-up.Study authors reported that these events were not related to the interventions.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Partly supported
  Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
  cites Bockting 2018 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Davies 2019 found withdrawal symptoms are o en severe and may last from a few weeks to several months or even longer.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Supported
  The Severity section reports that nearly half of people who experienced withdrawal effects selected the most severe response option in four large studies. The Duration section reports symptoms lasting beyond several weeks in a substantial proportion of people, with some reports extending beyond a year. The claim reflects both findings. (LLM, conf=0.92)
  cites Davies 2019 sourceExperimental — accuracy not yet measured
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Recently, it has been recognised that very low doses of antidepressants have significant effects on target receptors, suggesting that pharmacologically informed rational tapering of antidepressants requires reduction to very low doses before stopping (perhaps 1/40th of regular therapeutic doses) (Horowitz 2019).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Supported
  The Pharmacological principles section explains that low SSRI doses still affect serotonin transporter occupancy and recommends hyperbolic tapering to very small final doses. The paper also describes tapering strips reaching 0.5 mg for paroxetine and citalopram—about 1/40 of a 20 mg dose. Its specific pharmacological analysis concerns SSRIs rather than every antidepressant class. (LLM, conf=0.90)
  cites Horowitz 2019 source
Strength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“A recent review suggested incidence rates between 27% and 86%, with an average incidence of 56%, reduced to 50.7% when restricted to RCTs (6 studies), and excluding observational studies and online surveys (Davies 2019).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Supported
  Section 3.2 (Incidence) reports rates of 27%–86% across 14 studies and a combined weighted average of 55.7%, reasonably rounded to 56%. It separately reports 50.7% for the six RCTs, excluding the surveys and naturalistic studies from that subgroup calculation. (LLM, conf=0.94)
  cites Davies 2019 source
Load-bearingStrength:hedged· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Overall, the prognosis of a first episode of depression is positive, with 50% to 60% achieving stable recovery, 35% to 40% experiencing at least one recurrence in the next 15 years, and 15% developing chronic depression (Eaton 2008;Mattisson 2007;Moffit 2010).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Partly supported
  The Conclusions report that about half of first-onset cases recover without further episodes, 35% recur, and 15% remain unremitting. The 15-year qualifier is not supported for the stated 35%–40% recurrence rate: the Results give about 38% after 10 years and describe about half of the first-onset group as having recurred after 15 years. No page numbers are available in our copy. (LLM, conf=0.86)
  cites Eaton 2008 sourceExperimental — accuracy not yet measured
- Not checked — no full text of the sourcecites Mattisson 2007 source
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Moffit 2010
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Information is lost when continuous data are transformed to dichotomous data and the data can be influenced by data distribution and the cut-off point selected (Jakobsen 2017).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Potential biases in the review process
What the sources say
- Supported
  The Discussion states that transforming continuous data into dichotomous data loses information and that results can be greatly influenced by the data distribution and the choice of cut-point. This directly supports the cited sentence. (LLM, conf=0.95)
  cites Jakobsen 2017 source
Load-bearingStrength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“however, discontinuation of long-term antidepressants could be considered in other contexts, for example, prescribing in the context of medicalising”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Partly supported
  Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
  cites Johnson 2017 sourceExperimental — accuracy not yet measured
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Pilgrim 1999
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Ulfarson 2003
Strength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one. The quote only partly states this claim.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In contrast, the mean duration of antidepressant treatment is longer than two years in the UK (Johnson 2012: Petty 2006), four years in Australia (Kjosavik 2016), and longer than five years in the United States (Mojtabi 2014; Pratt 2011).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Partly supported
  The Results (p. 1) report that 47.1% of antidepressant users in the Scottish study were classified as long-term users, defined in Patients (p. 2) as taking the same antidepressant for at least two years. The paper does not report a mean treatment duration or establish that the UK mean exceeds two years. The Australia and US figures are attached to other citations, not Johnson 2012. (LLM, conf=0.82)
  cites Johnson 2012 sourceExperimental — accuracy not yet measured
- Not checked — no full text of the sourcecites Petty 2006 source
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Kjosavik 2016
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Dichotomisation is a potential concern and has been criticised by several authors (Altman 2006: Jakobsen 2017: Kirsch 2007: Munkholm 2019).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Potential biases in the review process
What the sources say
- Not checked — no full text of the sourcecites Altman 2006 source
- Supported
  The Discussion warns that transforming continuous data into dichotomous data loses information and that results can depend greatly on an arbitrary cut-point. This directly supports describing dichotomisation as a potential concern; the paper also cites other authors on the issue. No page number is available in our copy. (LLM, conf=0.93)
  cites Jakobsen 2017 source
- Not checked — no full text of the sourcecites Kirsch 2007 source
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“They found no difference in recurrence or quality of life between MBCT and tapering versus maintenance antidepressants treatment (2 studies).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Partly supported
  The “Recurrence After More Than 6 Months” section reports no difference in recurrence between MBCT with tapering support and maintenance antidepressants in a meta-analysis of two studies. The “Quality of Life” section reports no significant difference at 12 months or later, but a significant difference favoring MBCT with tapering support in psychological and social quality-of-life domains after one month. The claim omits that short-term exception. (LLM, conf=0.89)
  cites Maund 2019 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“One review author (TK) was involved in two ongoing trials (Duffy 2019; ISRCTN12417565).None of the other review authors was involved in any of the included trials.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Potential biases in the review process
What the sources say
- Supported
  The citation to Duffy 2019 identifies one of the two ongoing trials, not both trials or the review authors’ involvement in included trials. Tony Kendrick (TK) is an author of this protocol; the Contribution section says all authors contributed to the trial’s design, management and conduct, and Trial status says recruitment was ongoing at the time of writing. (LLM, conf=0.91)
  cites Duffy 2019 source
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites ISRCTN12417565
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“we did identify two RCTs that assessed discontinuation of antidepressants among older people in nursing homes without a documented history of depression or anxiety”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Partly supported
  The Patients section describes a randomised trial of antidepressant discontinuation in Norwegian nursing-home residents and says people with a documented depressive disorder were excluded. It does not say that a history of anxiety was checked or excluded, so the claim about residents without a documented history of anxiety is not established by this paper. The citing authors’ count of two RCTs is their review finding, not a claim this individual trial needs to establish. (LLM, conf=0.84)
  cites Bergh 2012 sourceExperimental — accuracy not yet measured
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Ulfarson 2003
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“the STAR-D trial raises questions about the long-term effects of antidepressants and suggests overestimation of their effects (Pigott 2015).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Supported
  In the Methods section (page not provided), Pigott questions the durability of antidepressant treatment gains during STAR*D’s 12-month follow-up, reporting high relapse and dropout rates. The paper also argues that the trial’s widely cited remission rates relied on unrealistic assumptions and overstated the observed outcomes. (LLM, conf=0.92)
  cites Pigott 2015 source
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Based on one RCT -Eveleigh 2018 -and one uncontrolled trial -Johnson 2012, they concluded that prompting GPs to review participants on long-term antidepressants was not an effective intervention to discontinue antidepressants (Maund 2019).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eveleigh 2018
- Supported
  Johnson 2012 is the study identified as the uncontrolled evaluation: its Aim and Method (p. 1) describe GP reviews of long-term antidepressant users with pre- and post-review measurements, rather than a randomized comparison. The conclusion that prompting GPs was not effective is attributed to Maund 2019 in the citing sentence, not to Johnson 2012. (LLM, conf=0.89)
  cites Johnson 2012 source
- Partly supported
  The Discontinuation of Antidepressants section reports no significant difference between clinician letters with tapering advice (6% discontinuation) and usual care (8%); its table also reports 7% discontinuation in Johnson’s single-arm trial. The Summary of Main Findings describes these as low rates for prompted primary-care review and guided tapering. However, the table identifies the Eveleigh RCT as 2015, not 2018. (LLM, conf=0.86)
  cites Maund 2019 sourceExperimental — accuracy not yet measured
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Maund 2019 included observational studies and excluded placebocontrolled trials.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Partly supported
  The Results section reports that the review included two retrospective cohort studies, supporting the observational-studies portion. The Study Inclusion and Exclusion section excludes placebo-controlled trials aimed only at testing maintenance antidepressants to prevent relapse or recurrence; it does not state a blanket exclusion of all placebo-controlled trials. (LLM, conf=0.86)
  cites Maund 2019 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“A previous review that did not specifically focus on long-term use found that continuation of antidepressant treatment for anxiety disorders resulted in lower relapse rates among responders compared with treatment discontinuation (28 studies) (Batelaan 2017).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Supported
  The Discussion reports that this meta-analysis of 28 studies found a clear benefit of continuing antidepressants rather than discontinuing them among patients with anxiety disorders who had responded to treatment. The Abstract specifies that relapse rates were lower with continuation during follow-up of up to one year, consistent with the citing sentence’s distinction from long-term use. (LLM, conf=0.94)
  cites Batelaan 2017 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Systematic reviews have reported that barriers to and facilitators of discontinuing antidepressants are numerous and complex (Maund 2018: Scholten 2020).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Implications for research
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Maund 2018
- Partly supported
  The Abstract and Conclusion describe multiple barriers to discontinuation, and the clinical recommendations discuss ways to facilitate it. But the Abstract explicitly calls Scholten 2020 a narrative review, not a systematic review, so the claim mischaracterizes the type of review. (LLM, conf=0.88)
  cites Scholten 2020 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, as is the case for our review, withdrawal confounding bias could have resulted in overestimation of the effectiveness of antidepressants.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Supported
  The Discussion states that falsely interpreting withdrawal symptoms as relapse would overestimate the protective effect of continuing antidepressants. It also describes reasons the authors believed this bias was limited in their review; the citing sentence’s ‘could have’ appropriately expresses a possibility, not an established overestimate. No page number is available in our copy. (LLM, conf=0.92)
  cites Batelaan 2017 source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one. The quote only partly states this claim.
Every source the paper cites for this claim was checked and supports it.
In the paper
“The discontinuation rate in the discontinuation intervention group was reported in eight studies and varied widely, from 6% to 95%.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Supported
  The Discontinuation of Antidepressants section states that eight studies reported discontinuation, with cessation rates ranging from 6% to 95%. Table 1 identifies those rates in the intervention arms. (LLM, conf=0.95)
  cites Maund 2019 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Given that withdrawal symptoms are common, participants may be aware if randomised to the discontinuation group, thereby compromising blinding and introducing bias (Moncrieff 2004).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Potential biases in the review process
What the sources say
- Partly supported
  The Background (page unavailable) says that differing experiences of an antidepressant and placebo may reveal treatment allocation and introduce bias. It does not say that withdrawal symptoms are common or address participants identifying assignment to a discontinuation group; the review concerns antidepressant-versus-placebo trials. (LLM, conf=0.88)
  cites Moncrieff 2004 sourceExperimental — accuracy not yet measured
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
Every source the paper cites for this claim was checked and supports it.
In the paper
“A recent non-systematic review showed that short tapers of between two and four weeks have minimal benefit over abrupt discontinuation, and that short tapering regimens such as these o en are not tolerated by patients (Horowitz 2019).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Supported
  The paper’s Abstract states that recommended two-to-four-week tapers show minimal benefit over abrupt discontinuation and are often not tolerated by patients. The tapering discussion also reports that a four-week regimen was not feasible for many patients. (LLM, conf=0.95)
  cites Horowitz 2019 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“71% of the 895 participants (97% of whom had experienced some withdrawal previously) discontinued their medication over a median of 56 days, with 68% still off their antidepressant a er one to five years (Groot 2018Groot 2020).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not checked — no full text of the sourcecites Groot 2018 source
- Partly supported
  The Introduction reports a previously observed 71% short-term discontinuation rate and a median of two 28-day taperingstrips, but does not give the claimed 895 participants. The Results report that, among 408 antidepressant users assessed after 1–5 years, 66% remained off medication; the 68% success rate also includes 2% who reduced their dose but remained on medication. The sentence therefore combines results from different assessments and incorrectly describes the 68% as still off antidepressants. (LLM, conf=0.92)
  cites Groot 2020 sourceExperimental — accuracy not yet measured
Load-bearingStrength:plain· not yet calibratedn = 895
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Maund 2019 found higher risk of withdrawal symptoms with abrupt discontinuation compared with tapering in two studies (one RCT and one retrospective cohort study)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Partly supported
  The Abstract says two studies reported a higher risk of discontinuation symptoms with abrupt termination. But the Discontinuation Symptoms section and Table 2 distinguish their outcomes: the retrospective cohort found significantly more discontinuation syndrome after abrupt withdrawal, while the RCT found more discontinuation-emergent adverse events but no statistically significant difference in discontinuation syndrome. (LLM, conf=0.88)
  cites Maund 2019 sourceExperimental — accuracy not yet measured
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
Every source the paper cites for this claim was checked and supports it.
In the paper
“review authors recommended hyperbolic antidepressant tapering regimens based on the relationship between SSRI dose and the serotonin transporter occupancy and on findings that hyperbolically reducing doses of SSRI reduces their effect on the transporter in a linear manner (Horowitz 2019).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Supported
  The Abstract says the authors used PET data on SSRI dose and serotonin transporter occupancy to show that hyperbolic dose reductions produce a linear reduction in transporter inhibition, and recommends slow hyperbolic tapering. The Pharmacological principles section explains the dose–occupancy relationship and the proposed tapering regimen. (LLM, conf=0.94)
  cites Horowitz 2019 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
Every source the paper cites for this claim was checked and supports it.
In the paper
“These results are consistent with the findings of a previous review reporting consensus about tapering antidepressants slowly over a period of weeks or months to avoid withdrawal symptoms (Wilson 2015).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Supported
  The Discussion reports a general consensus to taper antidepressants slowly to avoid discontinuation symptoms. It also describes a recommended minimum four-week taper after long-term treatment, preferably extending over months, while noting uncertainty about the optimal schedule. (LLM, conf=0.94)
  cites Wilson 2015 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
Every source the paper cites for this claim was checked and supports it.
In the paper
“The intervention of this study met the definition of 'minimal intervention (Voshaar 2006) and therefore we added a new type of intervention.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Additional information
What the sources say
- Supported
  The Selection procedure, data extraction and quality assessment section (p. 1) defines minimal interventions as simple measures applicable to large groups, such as an advisory letter or meeting advising long-term benzodiazepine users to stop. The citation supports that definition; whether Eveleigh 2018 meets it and the decision to add a category are the citing authors’ own judgments. (LLM, conf=0.91)
  cites Voshaar 2006 source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“In one study, editorial and medical writing support was provided by a medical writer funded by the sponsor of the trial (Khan 2014); therefore we judged this study to be at high risk of other bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Other potential sources of bias
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“We judged one study as having unclear risk as the authors used last observation carried forward (LOCF) as the imputation method for missing data for secondary outcomes, and we considered this to be an inappropriate method in this context (see discussion) (Kuyken 2008).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Incomplete outcome data
What the sources say
- Not checked — no full text of the sourcecites Kuyken 2008 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Twelve studies included antidepressants for depressive disorder, and one study included antidepressants for panic disorder with or without agoraphobia (Rapaport 2001).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Effects of interventions
What the sources say
- Not checked — no full text of the sourcecites Rapaport 2001 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The most common reason for exclusion was that participants had received antidepressant treatment for less than six months (e.g.Dobson 2008, Walker 2000).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Excluded studies
What the sources say
- Not checked — no full text of the sourcecites Dobson 2008 source
- Not checked — no full text of the sourcecites Walker 2000 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“One study reported adjusted mean DESS total score over the first two weeks a er discontinuation and the proportion of participants with withdrawal syndrome based on DESS (Khan 2014).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Relapse (as defined by study authors)
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“This was measured in three studies, but only one reported data on withdrawal symptoms (Khan 2014).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Relapse (as defined by study authors)
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“We judged 20 studies receiving support from the pharmaceutical industry or reporting an unclear source of funding to be at unclear risk for industry sponsorship bias (Catalogue of Bias 2019) (Bialos 1982;Cook 1986;Derubeis 2019;Gelenberg 2003;Gilaberte 2001;Keller 1998;Keller 2007;Klysner 2002;Kocsis 1996;Kocsis 2007;Kornstein 2006;Montgomery 1988;Montgomery 2004;Perahia 2009;Peterson 2010;Rap”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Other potential sources of bias
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Catalogue of Bias 2019
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Bialos 1982 did not report the number of (serious) adverse events but reported only the insomnia factor and the autonomic anticholinergic factor of the Treatment-Emergent Symptoms Scale in the tapering group but not in the continuation group.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Relapse (as defined by study authors)
What the sources say
- Not checked — no full text of the sourcecites Bialos 1982 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The most commonly reported DESS symptoms on the DESS scale (by 10% or more participants) in the discontinuation group were irritability, trouble sleeping and/or insomnia, nervousness, anxiety, sudden worsening of mood, sudden outbursts of anger, bouts of crying or tearfulness, agitation, feeling unreal or detached, confusion or trouble concentrating, forgetfulness or problems with memory, mood”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.3.1 Types of withdrawal symptoms
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“Khan 2014 (n = 184) reported that one participant (1/148; number in control group split) in the abrupt discontinuation group reported suicidal ideation on the Columbia Suicide Severity Rating Scale during the discontinuation phase.The trial reported no suicidal behaviours.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibratedSingle case
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Kornstein 2006 (n = 139) reported one suicide attempt one month a er the last reported dose of blinded placebo in a participant with a history of suicide attempt in the discontinuation group (n = 66), and this was assessed by the investigator as 'possibly related' to study medication.However,”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not checked — no full text of the sourcecites Kornstein 2006 source
Strength:plain· not yet calibratedSingle case
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“Study authors reported that most DESS symptoms were rated as mild or moderate in severity.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.3.1 Types of withdrawal symptoms
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Khan 2014 reported mean (self-rated) Quick Inventory of Depressive Symptomatology Self-Report 16 total scores (QIDS-SR16) at the end of the trial: 6.5 (SD 4.7) in the abrupt discontinuation group (n = 146) and 6.7 (SD 4.8) in the continuation group (n = 36) (LCOF analysis).Study authors concluded that there were no clinically significant changes in QIDS-SR16 scores.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.5.3 Depressive symptoms measured with other scales
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibratedn = 146
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Study authors reported that most DESS symptoms were rated mild or moderate in severity.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.3.1 Types of withdrawal symptoms
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The DESS items most commonly reported to be severe were trouble sleeping/insomnia (4.1% of participants in the discontinuation group, and 4.2% in the antidepressant group) and nervousness/anxiety (4.1% in the discontinuation group, and 1.4% in the antidepressant group).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.3.1 Types of withdrawal symptoms
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“The most commonly reported symptoms on the DESS scale (by ≥ 10% of participants) in the discontinuation group were irritability, trouble sleeping and/or insomnia, nervousness, anxiety, sudden worsening of mood, sudden outbursts of anger, bouts of crying or tearfulness, agitation, feeling unreal or detached, confusion or trouble concentrating, forgetfulness or problems with memory, mood swings,”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.3.1 Types of withdrawal symptoms
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one. The quote only partly states this claim.
In the paper
“Mean MADRS score was 12.5 (standard deviation (SD) 11.5) in the discontinuation group (n = 94) and 7.8 (SD 9.7) in the continuation group (n = 109).Study authors concluded that fluvoxamine continuation was more effective than discontinuation (P < 0.001).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.5.3 Depressive symptoms measured with other scales
What the sources say
- Not checked — no full text of the sourcecites Terra 1998 source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedn = 94
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In one study (n = 160), 4 of 84 (4.8%) participants in the discontinuation group (with or without CBT) and 4 of 76 (5.3%) participants in the continuation group (with or without CBASP) experienced adverse events serious enough to discontinue the trial, but data on differences between groups were not reported (Gelenberg 2003).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.4.2 Studies with other outcome measures
What the sources say
- Not checked — no full text of the sourcecites Gelenberg 2003 source
Strength:plain· not yet calibratedn = 160
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Mean GDS score at endpoint was 5.03 (SD 1.15) in the discontinuation group (n = 13) and 5.11 (SD 0.86) in the continuation group (n = 23).Study authors concluded that there were no differences in GDS score.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.5.3 Depressive symptoms measured with other scales
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Streim 2012
Strength:plain· not yet calibratedn = 13
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“All studies measured relapse of depression except one, which reported relapse of panic disorder in participants with panic disorder (Rapaport 2001).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.2 Relapse (as defined by study authors)
What the sources say
- Not checked — no full text of the sourcecites Rapaport 2001 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Streim 2012 assessed also the numbers of participants experiencing one or more serious adverse events in the discontinuation group (4/13; 30.7%) and in the continuation group (8/23; 34.8%) but provided no data on differences between groups.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.4.1 Pooled studies
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Streim 2012
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Mean change from baseline to 28 weeks on the HAM-A Scale for participants with panic disorder was 3.95 (SD 7.35) in the discontinuation group (n = 89) and 1.65 (SD 7.01) in the antidepressant group (n = 92).Study authors reported no differences between groups (P = 0.154; P value obtained from (ANCOVA) model, with treatment, site, and baseline values as effects).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.6 Anxiety symptoms
What the sources say
- Not checked — no full text of the sourcecites Rapaport 2001 source
Load-bearingStrength:plain· not yet calibratedn = 89
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Rickels 2010 reported no differences in measurement of adverse events between antidepressant and discontinuation groups.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.3 Studies that could not be pooled
What the sources say
- Not checked — no full text of the sourcecites Rickels 2010 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Mean endpoint scores at four weeks were 6.2 (SD 4.5) in the taper group (n = 139) and 6.7 (SD 4.8) in the continuation group (n = 36), with no differences between groups.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.5.3 Depressive symptoms measured on other scales
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
Strength:plain· not yet calibratedn = 139
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“In the further six-month follow-up period, rates of antidepressant usage between the two groups continued to be highly significantly different (P < 0.0001), although no data on antidepressant use in both groups were provided.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.1 Successful discontinuation rate
What the sources say
- Not checked — no full text of the sourcecites Kuyken 2008 source
Strength:plain· not yet calibratedCausal:correlational· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Cook 1986 (n = 18) reported no differences in adverse events between discontinuation and antidepressant groups.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.3 Studies that could not be pooled
What the sources say
- Not checked — no full text of the sourcecites Cook 1986 source
Strength:plain· not yet calibratedn = 18
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Adverse events were not measured.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.4 Adverse events
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eveleigh 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Social and occupational functioning was not measured.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.9 Social and occupational functioning
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eveleigh 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Severity of illness was not measured.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.10 Severity of illness
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eveleigh 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“This study did not provide data on suicidality.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.11 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eveleigh 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Time to relapse was not measured.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.7 Time to relapse
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eveleigh 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Additionally, a minority of the studies assessed patients' preferences for outcomes (Eiring 2015): nine studies quality of life, and five of the 33 studies social and occupational functioning (e.g.daily activities, social activities, return to work).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eiring 2015
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim could be matched to a paper in Crossref, so there is nothing to check it against.
In the paper
“The duration of continuation treatment recommended in depression guidelines varies from four months to 12 months a er remission (APA 2010;CANMAT 2016;Declercq 2017;NHG 2012;NICE 2009;WHO 2017).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Continuation and maintenance treatment
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites APA 2010
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites CANMAT 2016
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Declercq 2017
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Evidence for treatment durations longer than nine months is relatively limited, with lack of long-term trials in which participants were randomised six months a er remission to determine the effects of treatment a er this time (Kaymaz 2008).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Continuation and maintenance treatment
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Kaymaz 2008
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Continuation treatment should be continued for at least two years a er remission for those at high risk of relapse (APA 2010;CANMAT 2016;Declercq 2017;NHG 2012;NICE 2009;WHO 2017), which is defined as having two or more episodes, residual symptoms, or severe previous episodes (Geddes 2003).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Continuation and maintenance treatment
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites APA 2010
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites CANMAT 2016
- Not checked — no full text of the sourcecites Geddes 2003 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“and almost all trials were conducted in secondary care and probably are not representative of primary care patients (Aroll 2017).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Continuation and maintenance treatment
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Aroll 2017
Strength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Reviews suggest that 30% to 50% of long-term antidepressant prescriptions had no evidence-based indication supporting their use, and that users could try to stop treatment (Ambresin 2015;Cruickshank 2008;Piek 2010).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Why it is important to do this review
What the sources say
- Not checked — no full text of the sourcecites Ambresin 2015 source
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Cruickshank 2008
- Not checked — no full text of the sourcecites Piek 2010 source
Load-bearingStrength:hedged· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“We recorded the selection process in sufficient detail to complete a PRISMA flow diagram (Moher 2009), along with Characteristics of included studies and Characteristics of excluded studies tables.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Selection of studies
What the sources say
- Not checked — no full text of the sourcecites Moher 2009 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Two review authors (EVL, LR) independently assessed each of the 33 included studies for risk of bias across the six domains, using the Cochrane 'Risk of bias' assessment tool (Higgins 2017), as described in the Methods (Assessment of risk of bias in included studies).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Risk of bias in included studies
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Higgins 2017
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The study did not make adjustments for withdrawal symptoms.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Comparison 4. Discontinuation with a minimal intervention versus usual care
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eveleigh 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We assessed the certainty of evidence for this outcome as low, downgraded by one level due to risk of bias (withdrawal confounding bias, attrition bias) and by one level due to imprecision (a single study).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.5 Depressive symptoms
Strength:plain· not yet calibrated
Tests✗ Asserted: fails✓ Checkable: passes✗ Load-bearing: fails✗ Based: fails
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
In the paper
“There was a high dropout rate in returning all three monthly self-report questionnaires: 32 of 70 (45%) participants in the discontinuation group and 33 of 76 (43%) did not have complete data.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.8 Quality of life
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eveleigh 2018
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
The quote only partly states this claim.
In the paper
“Eveleigh 2018 measured the prevalence and severity of antidepressant withdrawal symptoms using the Discontinuation-Emergent Signs and Symptoms (DESS) Scale as the outcome; however this was not analysed”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.3 Withdrawal symptoms
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Eveleigh 2018
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The recommended duration of tapering has been revised to four weeks or longer, particularly for drugs with a shorter half-life (such as paroxetine and venlafaxine) (NICE 2009).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites NICE 2009
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Very low-certainty evidence suggests that abrupt discontinuation of long-term antidepressants may increase relapse (10 studies) compared to continuation of antidepressant, but none of the studies distinguished between relapse and symptoms of withdrawal.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Abrupt discontinuation versus continuation of long-term antidepressants
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
In the paper
“Also, the UK Royal College of Psychiatrists guidelines now recommend 'months of tapering' (UK Royal College of Psychiatrists 2020).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites UK Royal College of Psychiatrists 2020
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Recently, the National Institute for Health and Care Excellence (NICE) has updated antidepressant guidelines to reflect severity and length of withdrawal symptoms related to”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Not checked — no full text of the sourcecites Iacobucci 2019 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A clear distinction between depression and anxiety is o en difficult in clinical practice (MaGPIe Research Group 2003).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Overall completeness and applicability of evidence
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites MaGPIe Research Group 2003
Strength:boosted· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The conclusion that suicide was”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Potential biases in the review process
What the sources say
- Not checked — no full text of the sourcecites Valuck 2009 source
Load-bearingStrength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“A previous Cochrane Review reported that sponsorship of drug studies by the manufacturing company leads to more favourable efficacy results and conclusions than sponsorship by other sources (Lundh 2017).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Potential biases in the review process
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Lundh 2017
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In the STAR-D trial, the largest naturalistic study of antidepressants so far conducted, the remission rate at one year for all participants taking antidepressants was 2.7% (108/4000), and 92.9% relapsed or dropped out (Pigott 2010).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not checked — no full text of the sourcecites Pigott 2010 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Two studies showed a very high discontinuation rate (87%) for CBT plus tapering compared to clinical management plus tapering (95%) (Fava 1994;Fava 1998a), and with no difference in relapse rates between groups a er 20 weeks.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not checked — no full text of the sourcecites Fava 1994 source
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Fava 1998a
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“However, these recommendations are based on consensus and were introduced into guidelines without evidence.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > A U T H O R S ' C O N C L U S I O N S Implications for practice
What the sources say
- Not checked — no full text of the sourcecites Geddes 2003 source
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Kaymaz 2008
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“These time points were based on the findings of the Geddes 2003 review, in spite of the fact that there was no association between relapse rate and duration of treatment in this review.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not checked — no full text of the sourcecites Geddes 2003 source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Despite the growing de-prescribing movement (Reeve 2017), only a few studies focused on de-prescribing long-term antidepressants have been undertaken.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Implications for research
What the sources say
- Not checked — no full text of the sourcecites Reeve 2017 source
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
It may state two separate claims as one.
In the paper
“Many studies did not systematically assess the harmful effects of antidepressants separately or did not report a safety composite endpoint, and this may be a source of potential bias (Warren 2020).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Potential biases in the review process
What the sources say
- Not checked — no full text of the sourcecites Warren 2020 source
Strength:hedged· not yet calibratedCausal:conditional· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Another systematic review found no evidence for treatment of a single episode for six to nine months, or for more than two episodes for longer than two years (Kaymaz 2008).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Kaymaz 2008
Load-bearingStrength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“The antidepressant discontinuation rate was low: 37% of participants discontinued their antidepressant over 16 months with no difference between groups, and only 28% discontinued their antidepressant without recurrence (Scholten 2018).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not checked — no full text of the sourcecites Scholten 2018 source
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“Study authors concluded that the absolute benefit of SSRIs in preventing depression recurrence is much smaller than was previously estimated, with a number needed to treat for an additional beneficial outcome (NNTB) of 8 (18 months).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Mangin 2015
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The retrospective cohort study found that withdrawal syndrome occurred significantly less frequently in patients who discontinued gradually compared with patients who discontinued abruptly, and most patients could discontinue paroxetine with a taper of 5 mg every two or four weeks (Himei 2006).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not checked — no full text of the sourcecites Himei 2006 source
Strength:plain· not yet calibratedCausal:direct· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
In the paper
“An unpublished primary care placebo-controlled discontinuation trial of maintenance SSRI treatment in New Zealand -one of our ongoing studies -found a recurrence rate of 23% in the taper arm over 18 months and 10% in the continuation arm, and 6% had to restart because of intolerable withdrawal symptoms despite tapering (Mangin 2015).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Agreements and disagreements with other studies or reviews
What the sources say
- Not matched
  Couldn’t be matched to a paper in Crossref, so it can’t be checked.
  cites Mangin 2015
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We performed an additional sensitivity analysis to test the impact of a long tapering scheme as current guidelines recommend tapering over 4 weeks and more.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Additional information
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: Guidelines currently advise tapering for at least four weeks.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“We conducted an additional post-hoc sensitivity analysis for industry sponsorship bias because drug companies whose primary interest may not be in discontinuation.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Additional information
Strength:plain· not yet calibrated
Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passes
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: Pharmaceutical companies may not have discontinuation as their main interest.

354 of 354

The paper relies on this without support.
The DESS scale validly measures antidepressant withdrawal syndrome.
“a withdrawal syndrome based on DESS Scale”
“withdrawal syndrome based on DESS scores”
The authors state this as an assumption.
The included studies would be too dissimilar and would display substantial clinical and methodological heterogeneity.
“We used a random-effects model because we assumed that the included studies would not be sufficiently similar and would show considerable clinical and methodological heterogeneity (Deeks 2017).”
The paper relies on this without support.
Psychological support may lead to higher risk of successful antidepressant discontinuation and lower risk of relapse.
“because psychological support may lead to higher risk of successful antidepressant discontinuation and lower risk of relapse.”
The paper relies on this without support.
Withdrawal symptoms are a fundamental outcome in drug discontinuation trials.
“although this is a fundamental outcome in drug discontinuation trials.”
The paper relies on this without support.
Clinical scale scores include domains that are symptoms of withdrawal.
“all of which are symptoms of withdrawal.”
The paper relies on this without support.
The HAM-D scale contains domains that are symptoms of withdrawal.
“The HAM-D scale contains domains for depressed mood, insomnia, agitation, gastrointestinal somatic symptoms, anxiety, general somatic symptoms, and sexual dysfunction, all of which are symptoms of withdrawal.”
The paper relies on this without support.
The HAM-A scale contains domain symptoms of psychic anxiety and somatic anxiety that are symptoms of withdrawal.
“It is important to note that HAM-A contains domain symptoms of psychic anxiety and somatic anxiety, all of which are symptoms of withdrawal.”
The paper relies on this without support.
Withdrawal symptoms including psychological symptoms may impair severity of illness.
“Withdrawal symptoms including psychological symptoms may impair the severity of illness.”
The paper relies on this without support.
The COVI Anxiety Scale may register anxiety and other symptoms of withdrawal.
“A weakness of the COVI Anxiety Scale is that anxiety and other symptoms of withdrawal may register on the COVI Anxiety Scale.”
The paper relies on this without support.
Low mood is a common withdrawal symptom.
“Low mood is a common withdrawal symptom, but none of these studies measured withdrawal symptoms nor made adjustments for withdrawal symptoms.”
The paper relies on this without support.
HAM-A scales contain symptoms from domains of psychic anxiety and somatic anxiety, all of which are symptoms of withdrawal.
“HAM-A scales contain symptoms from domains of psychic anxiety and somatic anxiety, all of which are symptoms of withdrawal.”
The paper relies on this without support.
Withdrawal symptoms may impair work, socialising, and emotional well-being (social functioning and emotional role functioning).
“Withdrawal symptoms may impair work, socialising, and emotional well-being (social functioning and emotional role functioning) because of disturbing physical and emotional symptoms.”
The paper relies on this without support.
Withdrawal symptoms may influence social and occupational functioning.
“Withdrawal symptoms may influence social and occupational functioning due to disturbing physical and emotional symptoms.”
The paper relies on this without support.
Withdrawal symptoms including psychological symptoms may impair the severity of illness.
“Withdrawal symptoms including psychological symptoms may impair the severity of illness.”
The paper relies on this without support.
Withdrawal symptoms may be misdiagnosed as adverse events.
“confounding withdrawal bias; withdrawal symptoms may be misdiagnosed as adverse events”
The paper relies on this without support.
Low mood as a withdrawal symptom may be misdiagnosed as depressive symptoms.
“low mood as withdrawal symptom may be misdiagnosed as depressive symptoms with scores from the HAM-D scale or other clinical scales”
The paper relies on this without support.
Withdrawal symptoms may impair quality of life measures.
“withdrawal symptoms may impair QoL measures”
The paper relies on this without support.
Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
“withdrawal confounding bias; withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant”
The paper relies on this without support.
Adverse events may include withdrawal symptoms.
“withdrawal confounding bias; adverse events may include withdrawal symptoms”
The paper relies on this without support.
Pharmaceutical companies may not have discontinuation as their main interest.
“because drug companies whose primary interest may not be in discontinuation.”
The paper relies on this without support.
Guidelines currently advise tapering for at least four weeks.
“as current guidelines recommend tapering over 4 weeks and more.”

21 of 21

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

The six-study severity analysis names a different scale for one study
Minor
The analysis says all six studies measured severity with CGI-S, but its description of Rickels 2010 says that study reported PGI-S scores.
Low-intensity intervention is both absent and assigned to a study
Minor
The intervention summary says no included study used low-intensity support for discontinuation, whereas the fourth comparison describes its included study as using a low-intensity intervention.
Severity-of-illness study count changes within the same analysis
Minor
The text identifies five studies and reports a five-study pooled result, but calls them six studies between those statements.
Removing studies is said to reduce an increased effect
Minor
The reported mean difference rises from 0.31 to 0.44 after the two studies are removed, contrary to the statement that its magnitude decreased.
Tapering withdrawal comparison gives two control-group sizes
Minor
The same Khan 2014 tapering comparison gives the continuation group as 37 participants and then uses 36 as its denominator.
Short Form scale labels are reversed in the abbreviations
Minor
The outcome-measures section identifies SF-36 as Short Form 36 and SF-12 as Short Form 12. The abbreviations list assigns the 36-item name to SF-12 and the 12-item name to SF-36.
Count of older-adult-only studies differs
Minor
The sample-size section names four studies that included only participants aged 65 or older, while the applicability discussion says there were three.
Four-week follow-up is classified inconsistently
Minor
The methods define four weeks or less as short-term follow-up, but the results place a four-week study in the medium-term category.
Abrupt-discontinuation relapse result names the wrong comparator
Minor
The relapse estimate is described as comparing abrupt discontinuation with discontinuation. The comparison and its two groups are instead discontinuation versus continuation.

9 of 9

Cited works that were retracted

Works this paper cites that were later retracted, from the retraction notices publishers deposit. Major when the notice came out before this paper was published.

Cites a retracted work: 10.1001/jamapsychiatry.2014.1054
Info
The cited work was retracted; the date of the notice is not on record.
Cited work 10.1001/jamapsychiatry.2014.1054 · retraction date not known · this paper published 2021-04-22

1 of 1

1 retracted

Effect of Cognitive Therapy With Antidepressant Medications vs Antidepressants Alone on the Rate of Recovery in Major Depressive Disorder: A Randomized Clinical Trial
Hollon, S. D., DeRubeis, R. J., Fawcett, J., Amsterdam, J. D., Shelton, R. C., Zajecka, J., Young, P. R., & Gallop, R. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2014.1054 · Cited by 179
Retracted
Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
Untitled work
(1992) · PubMed · Cited by 33,716
A rating scale for depression
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765
The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection
Ware, J. E., & Sherbourne, C. D. (1992) · Medical Care · doi:10.1097/00005650-199206000-00002 · Cited by 30,033

Flagged first, then by citations

Show all 293 references

14 of the 293 references couldn’t be matched to a known paper.

Research works printed but not linked: 13

Eveleigh, 2018, Withdrawal of unnecessary antidepressant medication: a randomised controlled trial in primary care, British Journal of General Practice Open, 1, bjgpopen17X1012
Huijbers MJ Data supplement to Huijbers et al. Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial British Journal of Psychiatry 2016 doi: 10.1192/bjp.bp.115.168971 · DOI · Paper page
Kornstein, 2014, Influence of sex and menopausal status on response, remission, and recurrence in patients with recurrent major depressive disorder treated with venlafaxine extended release or fluoxetine: analysis of data from the PREVENT study, Journal of Clinical Psychiatry, 75, 62, 10.4088/JCP.12m07841 · DOI
Mavissakalian, 1998, Gauging the effectiveness of extended imipramine treatment for panic disorder with agoraphobia, Biological Psychiatry, 43, 848–54, 10.1016/S0006-3223(97)00376-4 · DOI
Mavissakalian, 1999, Long-term maintenance and discontinuation of imipramine therapy in panic disorder with agoraphobia, Archives of General Psychiatry, 56, 821, 10.1001/archpsyc.56.9.821 · DOI
Streim, 2012, Antidepressant discontinuation associated with cognitive decline in older adult residents of long-term care facilities, American Journal of Geriatric Psychiatry, 1), S147
Mangin D Dowson C Mulder R Wells E Toop L Dowell T The effectiveness of maintenanceSSRI treatment in primary care depression to prevent recurrence: multicentre double blinded placebo controlled RCT Proceedings of the 2015 North American Primary Care Research Group (NAPCRG) 43rd Annual Meeting 2015
American Psychiatric Association Practice guideline for the treatment of patients with major depressive disorder dsm.psychiatryonline.org/doi/full/10.1176/appi.books.9780890425596.dsm04 · DOI
Beck, 1993, Beck Anxiety Inventory Manual
Deeks JJ Higgins JP on behalf of the Cochrane Statistical Methods Group Chapter 9. Analysing data and undertaking meta-analyses. In: Higgins JPT, Churchill R, Chandler J, Cumpston MS (editors), Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0 (updated June 2017), Cochrane, 2017 Available from www.training.cochrane.org/handbook
Van Weel-Baumgarten, 2012, The NHG guideline depression (second revision of the NHG guideline depressive disorder), Huisarts en Wetenschap, 55, 252
Review Manager 5 (RevMan 5) Nordic Cochrane Centre, The Cochrane Collaboration 2014
Rosenbaum, 1988, Selective serotonin reuptake inhibitor discontinuation syndrome: a randomized clinical trial, Biological Psychiatry, 44, 77, 10.1016/S0006-3223(98)00126-7 · DOI · Paper page

Sorted by citations

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2023 Update on Clinical Guidelines for Management of Major Depressive Disorder in Adults: Réseau canadien pour les traitements de l'humeur et de l'anxiété (CANMAT) 2023 : Mise à jour des lignes directrices cliniques pour la prise en charge du trouble dépressif majeur chez les adultes
Lam, R. W. M., Kennedy, S. H., Adams, G. C., Bahji, A., Beaulieu, S., Bhat, V., Blier, P., Blumberger, D. M., Brietzke, E. M., Chakrabarty, T., et al. (2024) · The Canadian Journal of Psychiatry · doi:10.1177/07067437241245384 · Cited by 435
Management of Depression in Adults: A Review
Simon, G. E., Moise, N., & Mohr, D. C. (2024) · JAMA · doi:10.1001/jama.2024.5756 · Cited by 234
Adverse Effects of Antidepressant Medications and their Management in Children and Adolescents
Strawn, J. R., Mills, J. A., Poweleit, E. A., Ramsey, L. B., & Croarkin, P. E. (2023) · Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy · doi:10.1002/phar.2767 · Cited by 211
The relationship between dose and serotonin transporter occupancy of antidepressants—a systematic review
Sørensen, A., Ruhé, H. G., & Munkholm, K. (2022) · Molecular Psychiatry · doi:10.1038/s41380-021-01285-w · Cited by 65
“The potential utility of the dose/occupancy relationship in guiding tapering to mitigate withdrawal symptoms has received recent interest by multiple groups [11, 12, 15], and was considered in a recent Cochrane review on approaches to antidepressant discontinuation [14] and in a recent iteration of a major guideline o…”
Background
Withdrawal Syndrome Following Discontinuation of 28 Antidepressants: Pharmacovigilance Analysis of 31,688 Reports from the WHO Spontaneous Reporting Database
Gastaldon, C., Schoretsanitis, G., Arzenton, E., Raschi, E., Papola, D., Ostuzzi, G., Moretti, U., Seifritz, E., Kane, J. M., Trifirò, G., et al. (2022) · Drug Safety · doi:10.1007/s40264-022-01246-4 · Cited by 68
“Second, when discontinuing antidepressants, clinicians should acknowledge the potential occurrence of withdrawal syndrome and recognise the corresponding symptoms, informing patients about this possibility and about any potential management strategies, instead of mainly focusing on the relapse risk [12].”
BackgroundInfluential
Remission of symptoms is not equal to functional recovery: Psychosocial functioning impairment in major depression
Yang, H., Gao, S., Li, J., Yu, H., Xu, J., Lin, C., Yang, H., Teng, C., Ma, H., & Zhang, N. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.915689 · Cited by 70
“(36), it was noted that five of the 33 studies included in the analysis assessed patients’ social and occupational functioning using five different instruments.”
Background
Clinical practice guideline recommendations on tapering and discontinuing antidepressants for depression: a systematic review
Sørensen, A., Juhl Jørgensen, K., & Munkholm, K. (2022) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253211067656 · Cited by 52
“Mean (SD) 62 (20) 42 (23) 27 (12) 21 (10) 6 (8) 30 (22) 17 (8)”
Comparative effects of 15 antidepressants on the risk of withdrawal syndrome: A real-world study using the WHO pharmacovigilance database
Quilichini, J.-B., Revet, A., Garcia, P., Bouquié, R., Hamard, J., Yrondi, A., & Montastruc, F. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.041 · Cited by 42
Successful use of tapering strips for hyperbolic reduction of antidepressant dose: a cohort study
Groot, P. C., & van Os, J. (2021) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253211039327 · Cited by 38
The sense of stopping migraine prophylaxis
Al-Hassany, L., Lyons, H., Boucherie, D. M., Farham, F., Lange, K. S., Marschollek, K., Onan, D., Pensato, U., Storch, E., Torrente, A., et al. (2023) · The Journal of Headache and Pain · doi:10.1186/s10194-023-01539-8 · Cited by 40
“Tapering off antidepressants is intended to give the body time to adapt [34].”
Background
Newer generation antidepressants and withdrawal effects: reconsidering the role of antidepressants and helping patients to stop
Horowitz, M., & Wilcock, M. (2022) · Drug and Therapeutics Bulletin · doi:10.1136/dtb.2020.000080 · Cited by 33
Self-citation
‘Never change a winning team’: GPs’ perspectives on discontinuation of long-term antidepressants
Leeuwen, E. V., Anthierens, S., van Driel, M., Sutter, A. D., van den Branden, E., & Christiaens, T. (2021) · Scandinavian Journal of Primary Health Care · doi:10.1080/02813432.2021.2006487 · Cited by 29
“An important group of people on long-term antidepressants can stop the antidepressant [27].”
BackgroundSelf-citation
TNF-α/TNFR1 activated astrocytes exacerbate depression-like behavior in CUMS mice
Gao, M., Song, Y., Liu, Y., Miao, Y., Guo, Y., & Chai, H. (2024) · Cell Death Discovery · doi:10.1038/s41420-024-01987-4 · Cited by 29
“In addition, approximately 50% of patients with major depression have problems with recurrent illness and relapse [6].”
Background
Antidepressant discontinuation syndrome: A state-of-the-art clinical review
Fornaro, M., Cattaneo, C. I., Berardis, D. D., Ressico, F. V., Martinotti, G., & Vieta, E. (2022) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2022.10.005 · Cited by 31
The costs incurred by the NHS in England due to the unnecessary prescribing of dependency-forming medications
Davies, J., Cooper, R. E., Moncrieff, J., Montagu, L., Rae, T. C., & Parhi, M. (2021) · Addictive Behaviors · doi:10.1016/j.addbeh.2021.107143 · Cited by 28
Prophylactic effects or withdrawal reactions? An analysis of time-to-event data from antidepressant relapse prevention trials submitted to the FDA
Hengartner, M. P., & Plöderl, M. (2021) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253211032051 · Cited by 23
Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis
Krijnen-de Bruin, E., Scholten, W., Muntingh, A., Maarsingh, O., van Meijel, B., van Straten, A., & Batelaan, N. (2022) · PLOS ONE · doi:10.1371/journal.pone.0272200 · Cited by 23
“The frequent occurrence of discontinuation symptoms and relapse after discontinuation [42, 43] might play a part in this preference.”
Background
“Stabilise-reduce, stabilise-reduce”: A survey of the common practices of deprescribing services and recommendations for future services
Cooper, R. E., Ashman, M., Lomani, J., Moncrieff, J., Guy, A., Davies, J., Morant, N., & Horowitz, M. (2023) · PLOS ONE · doi:10.1371/journal.pone.0282988 · Cited by 23
“For example, a systematic review of approaches to stop antidepressants found most tapering regimens lasted four weeks or less and conclusions could not be drawn about the most effective and safe way to stop this medication [43].”
BackgroundSelf-citation
Internet and Telephone Support for Discontinuing Long-Term Antidepressants
Kendrick, T., Stuart, B. L., Bowers, H. M., Sadeghi, M. H., Hl, P., Dowrick, C. F., Moore, M. V., Gabbay, M., Leydon, G., Yao, G., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.18383 · Cited by 22
Self-citation
Efficacy and safety of gut microbiome-targeted treatment in patients with depression: a systematic review and meta-analysis
Pan, B., Pan, Y., Huang, Y., Yi, M., Hu, Y., Lian, X., Shi, H., Wang, M., Xiang, G., Yang, W., et al. (2025) · BMC Psychiatry · doi:10.1186/s12888-024-06438-z · Cited by 21
“While antidepressants may be effective, their therapeutic effects typically take up to six weeks to manifest and are often associated with common side effects [3].”
Withdrawing from SSRI antidepressants: advice for primary care
Palmer, E. G., Sornalingam, S., Page, L., & Cooper, M. (2023) · British Journal of General Practice · doi:10.3399/bjgp23x732273 · Cited by 20
Discontinuing antidepressants: Pearls and pitfalls
Zwiebel, S. J., & Viguera, A. C. (2022) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.89a.21020 · Cited by 18
In Vitro Mechanistic Studies of a Standardized Sustainable Grape Seed Extract for Potential Application as a Mood-Modulating and Cognition-Enhancing Supplement
Hasbal‐Celikok, G., Kara, M., Sánchez, M., Owsianik, C., Gómez-Serranillos, M. P., Yilmaz‐Ozden, T., Öztaş, E., Zengin, Ö. S., Özhan, G., Arda, N., et al. (2024) · Nutrients · doi:10.3390/nu16203459 · Cited by 16
General practitioners’ perspectives on discontinuation of long-term antidepressants in nursing homes
Leeuwen, E. V., Anthierens, S., van Driel, M., Sutter, A. I. M. D., van den Branden, E., & Christiaens, T. (2022) · European Journal of General Practice · doi:10.1080/13814788.2022.2038131 · Cited by 16
“In line with this, and to provide clear guidelines for AD treatment duration in older adults, we need more studies investigating the effectiveness and safety of long-term AD, particularly in the oldest and most frail [24].”
BackgroundSelf-citation
Identifying priorities for future research on reducing and stopping psychiatric medication: results of a James Lind Alliance priority-setting partnership
Boland, M., Higgins, A., Beecher, C., Bracken, P., Burn, W., Cody, A., Framer, A., Gronlund, T., Horowitz, M., Huff, C., et al. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-088266 · Cited by 14
Self-citation
Trends in sales of antidepressants in Brazil from 2014 to 2020: A time trend analysis with joinpoint regression
Hoefler, R., Tiguman, G. M. B., Galvão, T. F., Ribeiro‐Vaz, I., & Silva, M. T. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.11.069 · Cited by 15
Anticholinergic drugs and dementia: time for transparency in the face of uncertainty
Woodford, H. J., & Stevenson, J. M. (2021) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.ed000154 · Cited by 12
Patterns, predictors, and patient-reported reasons for antidepressant discontinuation in the WHO World Mental Health Surveys
Kazdin, A. E., Harris, M., Hwang, I. H., Sampson, N. A., Stein, D. J., Viana, M. C., Vigo, D., Wu, C., Aguilar‐Gaxiola, S., Alonso, J., et al. (2023) · Psychological Medicine · doi:10.1017/s0033291723002507 · Cited by 11
“As might be expected, discontinuation is associated with an increased likelihood of relapse and risk of suicide (Liu et al., 2021; Sirey et al., 2017; Van Leeuwen et al., 2021).”
Background
Absetzen von Antidepressiva – Absetzsymptome und Rebound-Effekte
Bschor, T., Bonnet, U., Pitzer, M., Baethge, C., Lieb, K., Gertz, H.-J., & Müller-Oerlinghausen, B. (2022) · Der Nervenarzt · doi:10.1007/s00115-021-01243-5 · Cited by 12
Development and acceptability of a decision aid for major depressive disorder considering discontinuation of antidepressant treatment after remission
Aoki, Y., Takaesu, Y., Baba, H., Iga, J., Hori, H., Inoue, T., Mishima, K., Tajika, A., & Kato, M. (2022) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12269 · Cited by 9
Rebound effect, discontinuation, and withdrawal syndromes associated with drugs used in psychiatric and neurological disorders
Wisłowska-Stanek, A., Jarkiewicz, M., & Mirowska-Guzel, D. M. (2024) · Pharmacological Reports · doi:10.1007/s43440-024-00689-z · Cited by 11
“The Cochrane database suggests that the gradual discontinuation of antidepressants together with psychotherapy decreases the risk of discontinuation syndrome [89].”
An assessment of the reporting of tapering methods in antidepressant discontinuation trials using the TIDieR checklist
McGoldrick, A., Byrne, H., & Cadogan, C. A. (2023) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-023-01602-z · Cited by 10
“A secondary analysis was conducted of studies identified in a Cochrane systematic review of randomised controlled trials (RCTs) comparing the effectiveness and safety of approaches for discontinuing long-term antidepressant use (> 6 months) versus continuation of the medication [12].”
BackgroundMethodInfluential
Outcomes associated with antidepressant treatment according to the number of prescriptions and treatment changes: 5-year follow-up of a nation-wide cohort study
Vedrines, C. O., Lesuffleur, T., Cuerq, A., Fagot‐Campagna, A., Rachas, A., Gastaldi‐Ménager, C., Hoertel, N., Limosin, F., Lemogne, C., & Tuppin, P. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.923916 · Cited by 10
“Some of these poor outcomes may also be explained by detrimental neurophysiological adaptations to prolonged drug exposure or withdrawal effects (28).”
Background
Change in central nervous system‐active medication use following fall‐related injury in older adults
Hart, L. A., Walker, R. L., Phelan, E. A., Marcum, Z. A., Schwartz, N. R. M., Crane, P. K., Larson, E. B., & Gray, S. L. (2021) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17508 · Cited by 10
Disentangling pharmacological and expectation effects in antidepressant discontinuation among patients with fully remitted major depressive disorder: study protocol of a randomized, open-hidden discontinuation trial
Meißner, C., Warren, C. V., Fadai, T., Müller, A., Zapf, A., Lezius, S., Ozga, A., Falkenberg, I., Kircher, T. T. J., & Nestoriuc, Y. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04941-3 · Cited by 11
“(2021) concluded that tapering regimens up to four weeks do not reduce risk of discontinuation symptoms compared to abrupt discontinuation [28].”
BackgroundInfluential
A mixed-methods review and meta-synthesis of fears of recurrence and progression in people with mental health conditions
Coutts‐Bain, D., Sharpe, L., Techakesari, P., Forrester, M., & Hunt, C. J. (2023) · Clinical Psychology Review · doi:10.1016/j.cpr.2023.102342 · Cited by 10
Interventions to help patients withdraw from depression drugs: A systematic review
Gøtzsche, P. C., & Demasi, M. (2023) · International Journal of Risk & Safety in Medicine · doi:10.3233/jrs-230011 · Cited by 14
“A 2021 Cochrane review on approaches for discontinuation versus continuation of long-term drug use did not include trials comparing diﬀerent withdrawal strategies and it was restricted to adults with depression or anxiety [76].”
Antidepressant Discontinuation
Vinkers, C. H., Ruhé, H. G., & Penninx, B. W. J. H. (2021) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000001460 · Cited by 9
“Despite meta-analyses contrasting (variably) tapered discontinuation (with or without co-intervention) versus continuation in this Cochrane review, it did not report on comparisons between different discontinuation strategies.(17) After systematically reviewing PubMed and the Cochrane Trial Register (last search Febru…”
BackgroundMethodInfluential
The relationship between “microbiota-gut-brain” axis and depression: Chronic stress-induced inflammation
Wang, H., Wu, J., Wang, P., Wang, W., Gao, L., Liu, D., Ding, X., & Su, T. (2025) · Physiology & Behavior · doi:10.1016/j.physbeh.2025.114881 · Cited by 8
Health care professional barriers and facilitators to discontinuing antidepressant use: A systematic review and thematic synthesis
Leeuwen, E. V., Maund, E., Woods, C. J., Bowers, H. M., Christiaens, T., & Kendrick, T. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.04.060 · Cited by 10
Self-citation
MENTAL DISORDERS AND CARDIOVASCULAR DISEASES: GUIDELINES OF THE BAIKAL PSYCHOSOMATIC ASSOCIATION AND THE SIBERIAN PSYCHOSOMATIC ASSOCIATION
Fi, B., Sumin, A. N., Garganeeva, N. P., Ларева, Н. В., Петрова, М. М., Петрунько, О. В., Попонина, Т. М., Repin, A. N., & Собенников, В. С. (2024) · Complex Issues of Cardiovascular Diseases · doi:10.17802/2306-1278-2024-13-3s-222-253 · Cited by 8
What helps, what hinders antidepressant discontinuation? Qualitative analysis of patients’ experiences and expectations
Meißner, C., Meyrose, A., & Nestoriuc, Y. (2024) · British Journal of General Practice · doi:10.3399/bjgp.2023.0020 · Cited by 9
The pattern of medication use, and determinants of the prevalence of polypharmacy among patients with a recent history of depressive disorder: results from the pars cohort study
Ghaedsharaf, M., Hariri, S., Poustchi, H., Nourollahi, M., Khani, S., Taherifard, E., Mohammadi, Z., Hadipour, M., Sabaei, R., Gandomkar, A., et al. (2022) · BMC Psychology · doi:10.1186/s40359-022-00716-9 · Cited by 7
Depression and Anxiety Disorders
Karamustafalıoğlu, O., & Yumrukçal, H. (2025) · Wiley eBooks · doi:10.1002/9781119870203.mpg003.pub2 · Cited by 8
Frequency of self-reported persistent post-treatment genital hypoesthesia among past antidepressant users: a cross-sectional survey of sexual and gender minority youth in Canada and the US
Pirani, Y., Delgado‐Ron, J. A., Marinho, P., Gupta, A. K., Grey, E., Watt, S., MacKinnon, K. R., & Salway, T. J. (2024) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-024-02769-0 · Cited by 7
“Finally, patients need to stop treatment for the diagnosis to be made (necessary criterion) and, for many, the risks of discontinuation of treatment outweigh its potential benefits or may be challenging due to withdrawal effects [ 12, 13].”
Short-course antidepressant therapy reduces discontinuation syndrome while maintaining treatment efficacy in patients with refractory functional dyspepsia: A randomized controlled trial
Wang, Q., Cheng, L., Wu, B.-Y., Xu, P., Qiu, H.-Y., Wang, B., Yan, X.-J., & Chen, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1063722 · Cited by 8
Deprescribing: An umbrella review
Japelj, N., Horvat, N., Knez, L., & Kos, M. (2024) · Acta Pharmaceutica · doi:10.2478/acph-2024-0011 · Cited by 7
“to reduce the total number of inappropriate medications (13, 19, 21, 22, 24, 27, 31, 33, 34, 64–66).”
An update on pharmacotherapy for recurrent depression in 2022
Belge, J.-B., Sabbe, A. C. F., & Sabbe, B. (2023) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2023.2223962 · Cited by 5
Comparing the effects of resistance and aerobic exercise on mood-related symptoms and EEG activity in young healthy adults: A non-randomized pilot study
Yuk, K., Lim, J., & Moon, H. Y. (2024) · Mental health and physical activity · doi:10.1016/j.mhpa.2024.100626 · Cited by 5
A systematic review of manipulations to pharmaceutical dosage forms used in psychotropic tapering plans
O'Brien, D., Healy, A. M., Harkin, A., & Cadogan, C. A. (2025) · British Journal of Clinical Pharmacology · doi:10.1002/bcp.70082 · Cited by 5
A case report of pregabalin misuse leading to drug dependence
Luo, Y., Zhou, X., Xiang, A., Zeng, Y., Luo, J., Zhou, B., Guo, N., & Zhou, X. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1511168 · Cited by 4
Addressing depressive disorders among people with HIV.
Fuenmayor, A., & Cournos, F. (2022) · PubMed Central · Cited by 4
The missing link? Pharmacists’ perspectives on discontinuation of long-term antidepressants: a qualitative study
Leeuwen, E. V., Mehuys, E., Johnson, C. F. A., Keyzer, A.-S. D., Boussery, K., & Christiaens, T. C. (2025) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253251333977 · Cited by 4
Self-citation
Exploring Manipulated Prescribed Medicines for Novel Leads in 3D Printed Personalized Dosage Forms
Pannekoek, W., van Kampen, E. E. M., van Tienen, F., van der Kuy, P. H. M., & Ruijgrok, E. J. (2025) · Pharmaceutics · doi:10.3390/pharmaceutics17020271 · Cited by 3
“Lastly, some psychopharmaceuticals can induce dependency in patients and result in withdrawal symptoms, resulting in a therapeutic rationale to use manipulated medicine in order to phase out medication [38–42].”
Study protocol: combined N-of-1 trials to assess open-label placebo treatment for antidepressant discontinuation symptoms [FAB-study]
Müller, A., Konigorski, S., Meißner, C., Fadai, T., Warren, C. V., Falkenberg, I., Kircher, T. T. J., & Nestoriuc, Y. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05184-y · Cited by 4
The Impact of Payment Scheme Changes on Medication Adherence and Persistence of Patients Diagnosed with Depression in Korea
Shin, G., Jang, B., Bae, G., Jeon, H., & Bae, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191711100 · Cited by 4
“Antidepressants are prescribed to treat depression [2], but non-adherence and early discontinuation of prescribed medication are prevalent [3,4].”
Background
Antidepressant safe use, deprescription and switching guideline
Goñi, O. (2021) · Boletín de información farmacoterapéutica de Navarra · doi:10.54095/bitn20212904 · Cited by 1
Predicting intentions towards long-term antidepressant use in the management of people with depression in primary care: A longitudinal survey study
Dewar-Haggart, R., Müller, I., Bishop, F. L., Geraghty, A. W. A., Stuart, B. L., & Kendrick, T. (2025) · PLoS ONE · doi:10.1371/journal.pone.0299676 · Cited by 2
“…views towards intentions to stop taking antidepressants and concerns around symptoms of withdrawal and relapse during discontinuation [77,81,84,102–108], further discussions between the patient and GP around beliefs and attitudes towards long-term antidepressants are needed from the outset,…”
Self-citation
What predicts response to sertraline for people with depression in primary care? a secondary data analysis of moderators in the PANDA trial
Archer, C., Kessler, D. S., Lewis, G., Araya, R., Duffy, L., Gilbody, S. M., Lewis, G., Kendrick, T., Peters, T. J., & Wiles, N. (2024) · PLoS ONE · doi:10.1371/journal.pone.0300366 · Cited by 2
Self-citation
Interventions to help patients withdraw from depression drugs: systematic reviewPreprint
Gøtzsche, P. C., & Demasi, M. (2023) · medRxiv · doi:10.1101/2023.03.13.23287182 · Cited by 2
FKN/NR Signaling Pathway Regulates Hippocampal Inflammatory Responses: the Survival of Hippocampal Neurons in Diabetic Rats with Chronic Unpredictable Mild Stress
Liu, Z., Zhao, H., Liu, J., Han, Y., & Wang, Y. (2022) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2022/8980627 · Cited by 2
El panorama existente de la depresión. Revisión Bibliográfica
Salinas, M. A. F., Peláez, K. S. S., García, B. E. C., & Pesántez, S. A. V. (2022) · Ciencia Latina Revista Científica Multidisciplinar · doi:10.37811/cl_rcm.v6i4.3554 · Cited by 1
Mental Disorders in Patients with Cardiovascular Diseases. Consensus Statement by the Task Force of the Russian Society of Cardiology and the Russian Society of Psychiatrists
Fi, B., Veltishchev, D. Y., Volel, B. A., Garganeeva, N. P., Kopylov, F. Y., Lareva, N. V., Medvedev, V. E., Mosolov, S. N., Petrova, M. M., Петрунько, О. В., et al. (2025) · Kardiologiia · doi:10.18087/cardio.2025.6.n2921 · Cited by 2
A rare case of antidepressant discontinuation syndrome triggered by domperidone: Clinical insights and literature review
Barkho, A., Elhusein, B., & Gajebasia, N. (2025) · SAGE Open Medical Case Reports · doi:10.1177/2050313x251342973 · Cited by 1
“14 Desvenlafaxine is well known for its short half-life, a factor influencing the onset and severity of withdrawal symptoms.”
Discontinuation strategies and long-term outcome of antidepressant medications
Bakhiader, M. A., Alsultan, I., Alelowi, A., Aloufi, M., Almatrafi, S., Aljohani, F. M., Almuzaini, T., Shalaby, H., Abuhawi, Z., Nassif, R., et al. (2023) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20233549 · Cited by 1
Un sevrage progressif responsable et sûr à l’aide de Tapering strips
Musso, M., van Os, J., & Groot, P. C. (2022) · L information psychiatrique · doi:10.1684/ipe.2022.2506 · Cited by 1
“Cela a pour conséquence que le dispositif d’arrêt des traitements n’est pas adapté pour prévenir ce syndrome de sevrage et que lorsque les signes de sevrage surviennent, ils ne sont pas reconnus en tant que tels car une confusion existe entre symptômes de sevrage et rechute [11-12].”
Background
Mobile phone applications to support psychotropic tapering: a scoping review protocol
Boland, M., Higgins, A., Doherty, G. J., Sheaf, G., Framer, A., & Cadogan, C. A. (2022) · HRB Open Research · doi:10.12688/hrbopenres.13501.2 · Cited by 1
Perioperative Selective Serotonin Reuptake Inhibitor (SSRI) Use and Postoperative Fracture Fixation Outcomes: A Multi-institutional Retrospective Cohort Study
Ponna, A. K., Soma, S., Demetriou, Z. J., Giakas, A. M., & Ilyas, A. M. (2026) · Cureus · doi:10.7759/cureus.114976
“Any recommendation to withhold SSRIs perioperatively would require a far more robust and consistent evidence basis than is presently available [39,40].”
Patients’ experiences of antidepressant withdrawal: a narrative systematic review from a health promotion perspective
Bessone, M., & Nicholl, B. I. (2026) · Journal of Public Health · doi:10.1007/s10389-026-02779-z
Corticosteroid-Induced neuropsychiatric manifestations: From pathophysiology to management
Husain, A., & Ahmad, F. (2026) · Psychopharmacology · doi:10.1007/s00213-026-07084-x · Cited by 2
From In Vitro Genotoxicity Assays to Human Biomarkers: Interpreting DNA Damage Signals in Long-Term SSRI Therapy through a Translational Neurotoxicology Lens
Kamel, E. M., Khadrawy, S. M., Yassin, N. Y. S., et al. (2026) · Neurotoxicity Research · doi:10.1007/s12640-026-00795-1
Stopping antidepressants safely
Horowitz, M. A., & Perry, T. L. (2026) · African Journal of Primary Health Care & Family Medicine · doi:10.4102/phcfm.v18i1.5431
Self-citation
‘I Wish It Were More Often Told to People Before They Are Prescribed These Medications How Hard It Is to Get Off Them’: A Qualitative Descriptive Analysis of Free‐Text Responses to a Survey on Reducing and Stopping Psychiatric Medication
Boland, M., Higgins, A., Kwak, S., & Cadogan, C. A. (2025) · Health Expectations · doi:10.1111/hex.70384
“Tapering is the recommended approach for discontinuing psychiatric medication [15].”
For patients who are currently taking an antidepressant and are doing well, what is the likelihood of relapse after discontinuation of their medication?
Hill, F. M., Worstall, C., Rumschlag, T., & Ahmed, M. (2025) · Evidence-Based Practice · doi:10.1097/ebp.0000000000002470
Changes in the prescription of benzodiazepines and related drugs at month 12 after E2R hypnotherapy in previously treated patients: A descriptive study
Bastian, B., Martineau, F., Esvan, M., Mamoune, S. L., & Mener, É. (2025) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2025.101971 · Cited by 1
Literaturverzeichnis
(2025) · Elsevier eBooks · doi:10.1016/b978-3-437-21835-4.00116-5
Psychotherapie und Pharmakotherapie
Kapfhammer, H. (2025) · Elsevier eBooks · doi:10.1016/b978-3-437-21835-4.00046-9
Literaturverzeichnis zu Voderholzer (Hrsg.): Therapie psychischer Erkrankungen, 20. Auflage
(2024) · Elsevier eBooks · doi:10.1016/b978-3-437-21224-6.00055-4
Incidence of antidepressant withdrawal symptoms
Neto, N. N. M., & Mendes, J. M. (2024) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00242-6
Safe Deprescribing of Antidepressants
(2024) · Wiley eBooks · doi:10.1002/9781394291052.mdg002
Predicting intentions towards long-term antidepressant use in the management of people with depression in primary care: A longitudinal survey studyPreprint
Dewar-Haggart, R., Müller, I., Bishop, F. L., et al. (2024) · medRxiv · doi:10.1101/2024.02.16.24302927
Self-citation
THE EXISTING LANDSCAPE OF DEPRESSION: REVIEW
Salinas, M. A. F., García, B. E. C., Peláez, K. S. S., Mesias, M. S. P., Tapia, C. P. F., Perez, J. A. R., & Pesántez, S. A. V. (2022) · EPRA International Journal of Multidisciplinary Research (IJMR) · doi:10.36713/epra11089
Antidepressant safe use, deprescription and switching guideline
Goñi, O. (2022) · Boletín de información farmacoterapéutica de Navarra · doi:10.54095/bitn20212904en
Absetzen von Antidepressiva: Was sagt ein aktuelles Cochrane Review dazu?
Voderholzer, U. (2021) · PSYCH up2date · doi:10.1055/a-1550-9487
Absetzen nach Langzeitanwendung von Antidepressiva untersucht
(2021) · Allgemeinmedizin up2date · doi:10.1055/a-1522-0912
Stopzetten antidepressieve behandeling roept vooral veel vragen op
Finoulst, M., VANKRUNKELSVEN, P., Leeuwen, E. V., & Christiaens, T. C. (2021) · Tijdschrift voor Geneeskunde · doi:10.47671/tvg.77.21.086
Self-citation
For adults with depression and anxiety disorders, what are the effects of tapered discontinuation of long-term antidepressants?
Burch, J., & Tort, S. (2021) · Cochrane Clinical Answers · doi:10.1002/cca.3659
Antidepressants: Evidence on safe discontinuation is lacking, concludes Cochrane review
Torjesen, I. (2021) · BMJ · doi:10.1136/bmj.n1065
Additional file 1 of Disentangling pharmacological and expectation effects in antidepressant discontinuation among patients with fully remitted major depressive disorder: study protocol of a randomized, open-hidden discontinuation trial
Meißner, C., Warren, C. V., Fadai, T., Müller, A., Zapf, A., Lezius, S., Ozga, A.-K., Falkenberg, I., Kircher, T., & Nestoriuc, Y. (2024) · Figshare · doi:10.6084/m9.figshare.26598848
Additional file 2 of Study protocol: combined N-of-1 trials to assess open-label placebo treatment for antidepressant discontinuation symptoms [FAB-study]
Müller, A., Konigorski, S., Meißner, C., Fadai, T., Warren, C. V., Falkenberg, I., Kircher, T., & Nestoriuc, Y. (2024) · Figshare · doi:10.6084/m9.figshare.26626822
Additional file 2 of Disentangling pharmacological and expectation effects in antidepressant discontinuation among patients with fully remitted major depressive disorder: study protocol of a randomized, open-hidden discontinuation trial
Meißner, C., Warren, C. V., Fadai, T., Müller, A., Zapf, A., Lezius, S., Ozga, A.-K., Falkenberg, I., Kircher, T., & Nestoriuc, Y. (2024) · Figshare · doi:10.6084/m9.figshare.26598851
Additional file 1 of Study protocol: combined N-of-1 trials to assess open-label placebo treatment for antidepressant discontinuation symptoms [FAB-study]
Müller, A., Konigorski, S., Meißner, C., Fadai, T., Warren, C. V., Falkenberg, I., Kircher, T., & Nestoriuc, Y. (2024) · Figshare · doi:10.6084/m9.figshare.26626819

Authors: Van Leeuwen, E., van Driel, M. L., Horowitz, M. A., Kendrick, T., Donald, M., De Sutter, A. I., Robertson, L., & Christiaens, T.
Affiliations: Clinical Pharmacology Unit, Department of Basic and Applied Medical Sciences; Ghent University; Ghent Belgium
Department of Public Health and Primary Care; Ghent University; Ghent Belgium
University College London (GB)
University of Southampton (GB)
The University of Queensland (AU)
University of York (GB)
Ghent University (BE)
ORCID: Horowitz, Mark A
Kendrick, Tony
Donald, Maria
Christiaens, Thierry
Venue: Cochrane Database of Systematic Reviews
Publisher: Wiley
Published: 2021-04-22
Volume: 2026
Issue: 8
Pages: CD013495-CD013495
ISSN: 1361-6137 (ISSN-L)
1465-1858
DOI: 10.1002/14651858.cd013495.pub2
PMC: PMC8092632
OpenAlex: W3154690009
Cited by: 90
References: 293
Citations by year: 2026: 5 · 2025: 15 · 2024: 21 · 2023: 12 · 2022: 21 · 2021: 16
FWCI: 2.21
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Cochrane Database of Systematic Reviews (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
ePrints Soton (University of Southampton) (submittedVersion)
Funders: Bond University
National Institute for Health and Care Research
Department of Health and Social Care
Radboud Universiteit
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: antidepressant discontinuation, long-term antidepressant use, depression, anxiety disorders, antidepressant withdrawal symptoms, relapse, tapering, minimal intervention, adverse events, quality of life, social and occupational functioning, recurrent depression, adults, children, adolescents
MeSH terms: Drug Tapering, Adult, Antidepressive Agents, Anxiety Disorders, Depression, Humans, Quality of Life, Recurrence, Time Factors, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Withholding Treatment

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).

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Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults

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