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 accessAbstract
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
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Claims the paper makes
201 Own method · 183 Own result · 56 No full text of the sources · 53 No basis given · 42 Sources not found · 42 Own interpretation · 40 Partly supported · 27 Supported · 10 Not checked yet · 3 Supported so far · 2 Not supported · 2 Couldn’t confirm · 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
- Disputedcites Bockting 2018 sourceExperimental — accuracy not yet measured
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.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
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
- Disputedcites Baldwin 2006 sourceExperimental — accuracy not yet measured
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.
- Not checked — no full text of the sourcecites Bogetto 2002 source
- Not matchedcites Montgomery 2004a
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
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 supportedcites Hengartner 2020 sourceExperimental — accuracy not yet measured
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)
- Not checked — no full text of the sourcecites Recalt 2019 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
- Supportedcites Batelaan 2017 source
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)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
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 supportedcites Segal 2010 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
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 supportedcites Wilson 2003 sourceExperimental — accuracy not yet measured
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)
plainn = 113- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
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 supportedcites Segal 2010 sourceExperimental — accuracy not yet measured
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)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
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 supportedcites Bockting 2018 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
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 supportedcites Huijbers 2016 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
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
- Supportedcites Kuyken 2015 source
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“In all, 38 of 100 participants in the control group adhered to antidepressant treatment (maintaining ≥ 20 mg 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 supportedcites Bockting 2018 sourceExperimental — accuracy not yet measured
The Results report that 38 of 66 participants still in the antidepressants-alone group after six months adhered to the antidepressant protocol; 100 were originally assigned to that group. The Procedures specify a maintenance dose of at least 20 mg fluoxetine equivalent, but the claim uses the original group size as the adherence denominator rather than the 66 assessed at six months. (LLM, conf=0.89)
plainn = 100- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“There was no difference in risk of relapse (as defined by study authors) between participants discontinuing antidepressants with support from MBCT or PCT compared to those continuing antidepressants (HR 0.89, 95% CI 0.66 to 1.19; 690 participants, 3 studies).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.2.1 Pooled studies
What the sources say
- Partly supportedcites Bockting 2018 sourceExperimental — accuracy not yet measured
The Results report no significant difference in recurrence between PCT with antidepressant tapering and continued antidepressants (HR 0.86, 95% CI 0.56–1.32). The Discussion also describes three earlier MBCT trials as finding no clinically meaningful difference from maintenance medication. The paper does not report the claimed pooled HR of 0.89 (95% CI 0.66–1.19) for 690 participants across three MBCT-or-PCT studies. (LLM, conf=0.88)
- Not checked — no full text of the sourcecites Kuyken 2008 source
- Partly supportedcites Kuyken 2015 sourceExperimental — accuracy not yet measured
The Summary and Results report no significant difference in relapse for the PREVENT trial’s 424 participants (HR 0.89, 95% CI 0.67–1.18). The Systematic review section also describes pooling three trials, but reports a different measure and result: a relative risk of 0.76 (95% CI 0.59–0.98). It does not support the claimed three-study HR, confidence interval, 690 participants, or inclusion of PCT. Page numbers were not provided for these passages. (LLM, conf=0.88)
plainn = 690- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“and 29 of 212 (13.7%) reduced 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
- Partly supportedcites Kuyken 2015 sourceExperimental — accuracy not yet measured
Table 2 (Results; page not available) reports that 29 participants reduced their antidepressant dose, but this was among 176 participants who attended at least four MBCT-TS sessions (17%), not a reported 29 of 212 (13.7%). The table does not specify that their reductions were at least 50%. (LLM, conf=0.89)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Mean QALYs over 24 months were 1.59 (range 0.64 to 1.94) for the discontinuation with PCT group (n = 42) and 1.62 (range 0.95 to 1.95) for the continuation and PCT group (n = 104).”
§ 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
- Could not verifycites Bockting 2018 sourceExperimental — accuracy not yet measured
The Outcomes section (page unavailable) says cost-effectiveness results would be reported elsewhere; our copy does not report QALYs. The Results identify a 24-month follow-up and 104 participants allocated to PCT plus maintenance antidepressants, but do not give the claimed QALY means, ranges, or discontinuation-group sample of 42 (searched: QALYs, quality-adjusted life years, and the stated values). (LLM, conf=0.78)
plainn = 42- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Data show no differences between discontinuation and continuation in the physical domain (MD -0.22, 95% CI -2.16 to 1.73; 455 participants, 2 studies; I = 65%; random-effects model)”
§ 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 3.3.
What the sources say
- Not checked — no full text of the sourcecites Kuyken 2008 source
- Partly supportedcites Kuyken 2015 sourceExperimental — accuracy not yet measured
The Results report no evidence that mindfulness-based cognitive therapy with support to taper or discontinue antidepressants was superior to maintenance antidepressants on secondary outcomes, and include the WHO-QoL physical-health domain. But this is a single trial comparing treatment strategies, not a two-study random-effects analysis of discontinuation versus continuation; it does not report the quoted pooled mean difference, confidence interval, participant count, or I². (LLM, conf=0.88)
plainn = 455- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“or the social relations domain (MD 0.05, 95% CI -0.56 to 0.66; 455 participants, 2 studies; I = 9%; random-effects model) a er longterm 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) > See Analysis 3.3.
What the sources say
- Not checked — no full text of the sourcecites Kuyken 2008 source
- Partly supportedcites Kuyken 2015 sourceExperimental — accuracy not yet measured
The quality-of-life table (page unavailable in our copy) reports similar social-relationships scores for mindfulness-based cognitive therapy with support to taper or discontinue antidepressants and maintenance antidepressant treatment over follow-up. This single trial does not report the claimed pooled mean difference, confidence interval, 455 participants across two studies, or I² statistic; its intervention was not discontinuation alone. (LLM, conf=0.87)
plainn = 455- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Data show no difference in depressive symptom severity on the HAM-D scale between antidepressant discontinuation with MBCT and continuation of antidepressant (MD -0.42, 95% CI -1.82 to 0.98; 484 participants, 2 studies; I = 28%).”
§ 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 supportedcites Kuyken 2015 sourceExperimental — accuracy not yet measured
The paper’s Table 4 reports GRID-HAMD symptom scores for MBCT with tapering support and maintenance antidepressants, consistent with no clear difference between the groups. But the Results describe one trial with 424 participants; this paper does not report the claimed pooled mean difference, confidence interval, 484 participants across two studies, or I² statistic. (LLM, conf=0.88)
plainn = 484- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, there was no difference between discontinuation with MBCT and continuation of antidepressants in stable remitters (62% for MBCT and discontinuation, 59% for continuation of antidepressant; P = 0.77)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.2.2 Studies that could not be pooled
What the sources say
- Supportedcites Segal 2010 source
The Relapse section reports that, among stable remitters, MBCT and maintenance antidepressant medication (M-ADM) did not differ (P = .77). It gives adjusted relapse rates of 62% for MBCT and 59% for M-ADM. The Comment section confirms that patients receiving MBCT had discontinued antidepressant medication. (LLM, conf=0.95)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“and unstable remitters (28% for MBCT and discontinuation, 27% for continuation of antidepressant; HR 1.07, 95% CI 0.25 to 4.49; P = 0.93).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.2.2 Studies that could not be pooled
What the sources say
- Supportedcites Segal 2010 source
The Relapse section reports that, among unstable remitters, MBCT and maintenance antidepressants did not differ (P = .93), with adjusted relapse rates of 28% and 27%, respectively. It also gives the MBCT-versus-antidepressant hazard ratio as 1.07 (95% CI 0.25–4.49). No page number is available in our copy. (LLM, conf=0.95)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“the psychological domain (MD 0.37, 95% CI -0.75 to 1.49; 455 participants, 2 studies; I = 46%; random-effects model)”
§ 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 3.3.
What the sources say
- Not checked — no full text of the sourcecites Kuyken 2008 source
- Partly supportedcites Kuyken 2015 sourceExperimental — accuracy not yet measured
The Results table reports psychological quality-of-life scores for the trial’s two groups, MBCT-TS and maintenance antidepressant treatment, without a clear between-group difference. This is one randomised trial with 424 participants, not the claimed two-study random-effects analysis of 455 participants; the stated mean difference, confidence interval and I² are not reported in our copy. The indexed passages provide no page number. (LLM, conf=0.87)
plainn = 455- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Withdrawal reactions are common in clinical practice.”
§ 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
- Supportedcites Davies 2019 source
Section 3.2 (Incidence) reports withdrawal reactions in 27%–86% of participants across 14 studies, with a weighted average of 55.7%. This supports the broad claim that antidepressant withdrawal reactions are common, particularly following discontinuation. (LLM, conf=0.92)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“However, one included study found that most participants (60%) tapered antidepressants over 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) > Overall completeness and applicability of evidence
What the sources say
- Supportedcites Bockting 2018 source
The Procedures section states that, although clinicians were advised to taper antidepressants over four weeks, most individuals in the tapering group (60%) tapered with their doctors over six months. This directly supports the citing sentence. (LLM, conf=0.95)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Research suggests this could pertain to most relapses (El-Mallakh 2012; Greenhouse 1991; Hengartner 2020; Recalt 2019; Rosenbaum 1988).”
§ 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 El-Mallakh 2012 source
- Not checked — no full text of the sourcecites Greenhouse 1991 source
- Partly supportedcites Hengartner 2020 sourceExperimental — accuracy not yet measured
In “Withdrawal confounding in relapse prevention trials,” the paper says that possibly a majority of events recorded as relapses in the discontinuation arm of maintenance studies are due to withdrawal reactions. It also says withdrawal symptoms can be misdiagnosed as relapse, but distinguishes that from withdrawal triggering a genuine relapse. The claim does not preserve either distinction and extends the possibility beyond those trials. (LLM, conf=0.85)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“suggesting that a time frame of four weeks is not feasible for many long-term users of antidepressants (Bockting 2018).”
§ 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
- Supportedcites Bockting 2018 source
The Procedures section (page not specified in the excerpt) says that although clinicians were advised to taper antidepressants over four weeks, most participants (60%) tapered over six months. The authors explicitly interpret this as indicating that four weeks was not feasible for many individuals. (LLM, conf=0.94)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, this scale has been criticised because of its problems in differentiating between withdrawal and depressive symptoms (Fava 2015: Haddad 2007).”
§ 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 supportedcites Fava 2015 sourceExperimental — accuracy not yet measured
The Discussion says withdrawal symptoms can be mistaken for signs of depressive relapse, supporting the general difficulty in distinguishing them. It does not identify the HAM-D or criticise that scale specifically (searched: HAM-D and Hamilton Depression Rating Scale). The indexed passages provide no page number. (LLM, conf=0.85)
- Partly supportedcites Haddad 2007 sourceExperimental — accuracy not yet measured
The ‘Antidepressant discontinuation symptoms’ and ‘Differential diagnosis’ sections say withdrawal symptoms may be mistaken for recurrent depression and explain how clinicians can distinguish them. They do not mention the HAM-D or criticise its ability to make that distinction. The indexed passages do not specify individual page numbers. (LLM, conf=0.78)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A Canadian primary care study (n = 8119) found that antidepressants were prescribed longer than needed (15 months or longer, with a mean duration of 4.8 years) for 46% of patients (Mangin 2018).”
§ 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 supportedcites Mangin 2018 sourceExperimental — accuracy not yet measured
The Abstract and Main Study Findings report that 3,766 of 8,119 patients prescribed antidepressants (46%) met the legacy-prescribing threshold of longer than 15 months; their mean prescription duration was 4.8 years. But the Strengths and Limitations section says some prescriptions meeting the criteria may have been clinically appropriate and that individual appropriateness was beyond the study’s scope. Thus the study does not establish that treatment was longer than needed for every patient in the 46%. Page numbers were not provided in our copy. (LLM, conf=0.87)
plainn = 8,119- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Withdrawal symptoms may be misdiagnosed as relapse when relapse is assessed with the HAM-D scale (see above, Overall completeness and applicability of evidence) (Fava 2015: Haddad 2007).”
§ 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 supportedcites Fava 2015 sourceExperimental — accuracy not yet measured
The Discussion (page not provided) says SSRI withdrawal symptoms may be misidentified as signs of impending relapse. It does not link that risk specifically to assessing relapse with the HAM-D scale; searches for “HAM-D” and “Hamilton” found no such passage. (LLM, conf=0.86)
- Partly supportedcites Haddad 2007 sourceExperimental — accuracy not yet measured
The ‘Antidepressant discontinuation symptoms’ section says withdrawal symptoms may be diagnosed as relapse or recurrence, and ‘Nature of symptoms’ gives recurrence of depression as an example. The cited paper does not link that risk to assessment with the HAM-D scale. (LLM, conf=0.88)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“possibly because we pooled studies with their original longer duration (e.g.longer than 60 weeks) (as defined in our protocol) and included a later published study (Bockting 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
- Supportedcites Bockting 2018 source
The citation identifies Bockting 2018 as a later study the citing authors included, rather than attributing their explanation of the review’s result to it. The Procedures passage identifies this source as a preventive cognitive therapy trial and distinguishes its intervention from MBCT. Whether pooling longer study durations explains the review’s result is the citing authors’ own suggestion. (LLM, conf=0.85)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“but we could not confirm this finding”
§ 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
- Supportedcites Maund 2019 sourceExperimental — accuracy not yet measured
The Abstract reports that abrupt discontinuation was associated with more discontinuation symptoms. The Discontinuation Symptoms section supports the comparison most clearly for paroxetine: a retrospective cohort found discontinuation syndrome more frequent after abrupt cessation than gradual tapering. The cited review therefore reports the finding that the citing authors say they could not confirm. (LLM, conf=0.90)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Studies without active placebo are considered to be at unclear or high risk of performance bias (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
- Partly supportedcites Munkholm 2019 sourceExperimental — accuracy not yet measured
In Results > Risk of bias (page unavailable), the authors argue that placebo-controlled antidepressant trials should arguably be rated at least unclear, or perhaps high risk of bias because adverse effects can compromise blinding. Results > Summary risk of bias assessment says they rated those trials as unclear in the blinding domains. The citing sentence drops the antidepressant-trial scope and presents this qualified judgment as a general rule for studies without active placebo. (LLM, conf=0.84)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Our review could not confirm this significant effect at 60 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
- Supportedcites Kuyken 2016 source
The cited paper’s Results report a lower risk of depressive relapse for MBCT than for antidepressant medication (HR 0.77; 95% CI 0.60–0.98). Its Primary Outcome section specifies relapse within 60 weeks. The citing authors’ statement that their own review could not confirm this effect is not attributed to the cited paper. (LLM, conf=0.94)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“This finding is consistent with the findings of our 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
- Supportedcites Maund 2019 sourceExperimental — accuracy not yet measured
In Discontinuation of Antidepressants, the review reports no significant difference between clinician-directed discontinuation letters and usual care after 12 months (6% versus 8%). It also reports that only 7% discontinued after prompted primary-care clinician review; the Summary of Main Findings characterizes prompted review and guided tapering as having low discontinuation rates. The prompted-review study was single-arm, so its 7% rate alone does not establish a comparative effect. (LLM, conf=0.86)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Research suggests that most antidepressants are prescribed by GPs (Johnson 2017)”
§ 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
- Supportedcites Johnson 2017 source
The Background explicitly states that most antidepressants are prescribed by general practitioners (GPs). This directly supports the citing sentence. (LLM, conf=0.95)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Review authors found four studies -Groot 2013;Himei 2006;Murata 2010;van Geffen 2005 -showing that tapering over several months results in fewer withdrawal symptoms (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
- Partly supportedcites Horowitz 2019 sourceExperimental — accuracy not yet measured
The tapering discussion (page unavailable) reports better withdrawal outcomes for longer tapers in studies by Himei, van Geffen, and Murata. It also reports a favourable discontinuation outcome for a Groot study, but the References list that study as Groot and van Os (2018), not Groot (2013), and the reported outcome is successful discontinuation rather than fewer withdrawal symptoms. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“An individual-patient data meta-analysis found evidence that MBCT compared to continuation of antidepressant treatment was associated with a reduction in the risk of relapse or recurrence, with a hazard ratio (HR) of 0.77 (95% confidence interval (CI) 0.66 to 0.98) over 60 weeks (4 studies) (Kuyken 2016).”
§ 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 supportedcites Kuyken 2016 sourceExperimental — accuracy not yet measured
The Results section reports an individual-patient-data comparison of MBCT with antidepressant medication across four studies, with reduced relapse risk over 60 weeks and an HR of 0.77. The reported 95% CI is 0.60–0.98, not the claimed 0.66–0.98. (LLM, conf=0.92)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Risk of relapse (as defined by study authors) (HR) Follow-up: 64 to 104 weeks 556 per 1000 b 41 fewer per 1000 (from 113 to 38 more) HR 0.89 (0.66 to 1.19) 690 (3 RCTs) ⊕⊕⊝⊝ LOW c”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plainn = 690- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Mean QoL psychological health to-MD 0.37 higher -455 (2 RCTs)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plaindirectn = 455- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Depressive symptoms Assessed with HAM-D Scale Follow-up: 64 to 104 weeks Mean HAM-D total endpoint score ranged from 4.7 to 8.69 MD 0.42 lower (1.82 lower to 0.89 higher) -484 (2 RCTs) ⊕⊕⊝⊝ LOW e”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plainn = 484- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Anxiety symptoms None of the studies reported anxiety symptoms”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Mean QoL physical health total endpoint score ranged from 14.9 to 22.93 (2 studies) MD 0.22 lower (2.16 lower to 1.73 higher)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no differences in the proportions of participants with withdrawal syndrome based on DESS scores between the abrupt discontinuation group (31/146; 21.2%) and the continuation group (4/36; 11.1%) (P ≥ 0.06).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The DESS scale validly measures antidepressant withdrawal syndrome.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We included 33 studies described in 64 publications involving 4995 participants (see Characteristics of 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) > Included studies
plainn = 4,995- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In all, 13 studies compared abrupt discontinuation to continuation of long-term antidepressant treatment.”
§ 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 without psychological support (or psychological support as co-intervention)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Four studies compared discontinuation by”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" without psychological support (or psychological support as co-intervention)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No studies used low-intensity psychological intervention or psychosocial support to support discontinuation.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation in combination with support from low-intensity psychological intervention or psychosocial support
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Eight studies (with no pre-randomisation phase) included participants with long-term antidepressant treatment”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Antidepressant treatment Duration
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The definition of response/remission varied widely between studies”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Severity of depressive disorder/anxiety disorder at the moment of randomisation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the multi-phase RCTs, antidepressant duration before randomisation varied widely, at 24 weeks (Kane 1982; Khan 2014; Klysner 2002; Kornstein 2006; Mavissakalian 1999; Montgomery 1988; Montgomery 2004; Rickels 2010; Rouillon 2000; Terra 1998; Wilson 2003), 26 weeks (Kocsis 1996), 28 weeks (Gelenberg 2003; Keller 1998; Perahia 2009; Segal 2010), 30 weeks (Stewart 1997), 32 weeks (Gilaberte 2001),”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Antidepressant treatment Duration
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In prevention relapse discontinuation trials, only a subgroup of antidepressant users who responded to antidepressant treatment were randomised.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Participants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We judged all studies to be at high risk of bias in at least one domain.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Most studies excluded participants at high risk for suicide, drug abuse, anxiety disorders, and other Axis I or Axis II disorders (see Characteristics of 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) > Exclusion criteria
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No included studies used a changed pharmacological form or additional pharmacological support.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with changed pharmacological form (e.g. fluoxetine or paroxetine liquid) or with additional pharmacological support
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“None of the studies 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) > Selective reporting
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirteen studies (N = 1780) compared abrupt discontinuation with continuation of antidepressant (Gelenberg 2003; Gilaberte 2001 Kane 1982; Khan 2014; Klysner 2002; Kornstein 2006; Montgomery 1988 Peterson 2010; Rapaport 2001 Rouillon 2000; Streim 2012; Terra 1998; Wilson 2003);”
§ 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
plainn = 1,780- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Risk of allocation concealment bias was unclear in 22 studies as the method of concealment is not described or is not described in sufficient detail to allow a definitive judgement (Bialos 1982;Cook 1986;Derubeis 2019;Gelenberg 2003;Gilaberte 2001;Kane 1982;Keller 1998;Khan 2014;Klysner 2002;Kocsis 1996;Kornstein 2006;Kupfer 1992;Montgomery 1988;Montgomery 2004;Perahia 2009;Peterson 2010;Rapaport”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Allocation concealment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“2 of the 13 studies included psychological support as a co-intervention (CBT in Peterson 2010; CBASP in 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) > Effects of interventions
What the sources say
- Not matchedcites Peterson 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites Gelenberg 2003 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“We assessed eight studies including psychotherapy or minimal intervention as having high risk of performance bias (Bockting 2018;Derubeis 2019;Eveleigh 2018;Huijbers 2016;Kuyken 2008;Kuyken 2015;Segal 2010;Streim 2012).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Performance bias (blinding of participants and personnel)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Allocation concealment was described in sufficient detail to assess risk of bias as low in only 11 studies (Bockting 2018;Eveleigh 2018;Huijbers 2016;Keller 2007;Kocsis 2007;Kuyken 2008;Kuyken 2015;Mavissakalian 1999;Mavissakalian 2001;Segal 2010;Wilson 2003).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Allocation concealment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In all, 32 studies (97%) failed to include withdrawal symptoms, although this is a fundamental outcome in drug discontinuation trials.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“We judged the only cluster-RCT -Eveleigh 2018 -to be at low risk for cluster bias (Higgins 2017).”
§ 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 matchedcites Higgins 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We judged eight studies to be at low risk of attrition bias because there were no missing data, all study dropouts were reported, or the number of dropout participants was low (< 20%) and was similar across treatment groups (Bockting 2018;Cook 1986;Khan 2014;Kocsis 1996;Kupfer 1992;Kuyken 2015;Peterson 2010;Wilson 2003).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“None of the included studies compared discontinuation combined with low-intensity psychological intervention or psychosocial support or discontinuation with changed pharmacological form (e.g.fluoxetine or paroxetine liquid) to continuation of long-term antidepressants.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Data on suicide, suicide attempt, or suicidal ideation were not reported in 25 (76%) trials.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“None of the studies reported successful discontinuation rate as an outcome.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.1 Successful discontinuation rate
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“While following recommendations provided in the Cochrane Handbook for Systematic Reviews of Interventions, and in considering all relevant outcomes for a study-level judgement (Higgins 2017), we judged all studies except one to be at high risk of reporting bias (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) > Selective reporting
What the sources say
- Not matchedcites Higgins 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites Khan 2014 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants discontinuing antidepressants (n = 776) had higher risk of relapse (as defined by study authors) compared to those in the continuation group (n = 770) (Hazard Ratio 2.97, 95% CI 2.24 to 3.93; participants = 1546; studies = 13) without specific assessment of 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) > 2.2.2.1 Pooled studies
plaincorrelationaln = 1,546- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants in the discontinuation group had higher severity score rated on the CGI-S compared to those in the continuation group (MD 0.31, 95% CI 0.13 to 0.49), favouring antidepressant continuation (714 participants, 5 studies; I = 65%; random-effects model).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.9.1 Pooled studies
plaincorrelationaln = 714- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no difference in time to relapse between discontinuation versus continuation with psychotherapy as co-intervention in both groups (HR 1.48, 95% CI 0.93 to 2.34; 182 participants, 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) > 1.2.3 Studies with psychological support as co-intervention
plainn = 182- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Terra 1998 (n = 204) reported that two participants in the antidepressant group (n = 110) withdrew during the trial due to adverse events, along with zero participants in the discontinuation group (n = 94).”
§ 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 Terra 1998 source
plainn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Study authors reported there were no statistically significant differences between groups in the proportions of participants with withdrawal syndrome based on DESS scores (abrupt discontinuation 21.2%; continuation 11.1%; P ≥ 0.06).”
§ 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 Withdrawal symptoms
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These funnel plot showed low risk of publication bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.2.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These funnel plots showed low risk of publication bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.1.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Relapse was based on the criteria defined by study authors, which varied widely between studies.”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Most studies were based on clinical scale scores that include domains for depressed mood, insomnia, agitation, gastrointestinal somatic symptoms, anxiety, general somatic symptoms, and sexual dysfunction -all of which are 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) > 1.2 Relapse (as defined by study authors)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Clinical scale scores include domains that are symptoms of withdrawal.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We found higher risk of relapse (as defined by study authors) in the discontinuation group compared to continuation of antidepressant with psychological treatment as co-intervention (HR 1.90, 95% CI 1.42 to 2.53; 570 participants, 4 studies).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.3 Studies with co-intervention
plaincorrelationaln = 570- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants discontinuing antidepressants had higher risk of relapse (as defined by study authors) compared to those in the continuation group (Hazard Ratio 2.59, 95% CI 2.07 to 3.25; participants = 2120; studies = 16) without specific assessment of 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) > 2.2.1.1 Pooled studies
plaincorrelationaln = 2,120- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In all, 31 of the 146 participants in the discontinuation group experienced a withdrawal syndrome, along with 4 of the 36 participants 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) > 1.3 Withdrawal symptoms
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
plainn = 146- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Study authors reported no difference in depression between the discontinuation group (9/89; 10.1%) and the continuation group (9/92; 9.8%) (P = 1) (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) > See Analysis 1.1.
What the sources say
- Not checked — no full text of the sourcecites Rapaport 2001 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The most common adverse events amongst participants who continued their antidepressant included headache, asthenia, pain, flu-like symptoms, infection, back pain, nausea, traumatic injury, dyspepsia, somnolence and insomnia, upper airway infection, anxiety, decreased libido, nausea, abdominal pain, weight loss, psychiatric disorder, dizziness, and fatigue.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.4.3 Types of adverse events
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No study measured quality of life.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.7 Quality of life
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The most common adverse events (≥ 10%) among antidepressant discontinuers included headache, asthenia, malaise, depression, pain, abdominal pain, flu-like symptoms, infection, back pain, dyspepsia, insomnia, upper airway infection, anxiety, libido decreased, nausea, dysmenorrhoea (only in women), psychiatric disorder, dizziness, and malaise.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.4.3 Types of adverse events
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No study measured social and occupational functioning.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.8 Social and occupational functioning
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No studies reported a successful discontinuation rate.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.1.2 Studies without psychological support as co-intervention
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Rouillon 2000 (n = 214) reported two participants with two suicide attempts in each group.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not matchedcites Rouillon 2000
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Data show no differences in the proportions of participants with withdrawal syndrome based on DESS scores between the discontinuation group (30/139; 21.6%) and the continuation group (4/36; 11.1%) (P ≥ 0.06).”
§ 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 2.2.
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No difference in the severity of depressive symptoms was measured by the HAM-D scale between participants in the discontinuation group and those in the continuation group (mean difference (MD) 0.44, 95% CI -1.12 to 2.00; 330 participants, 3 studies; I = 85%; random-effects model).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.5.1 Pooled studies
plainn = 330- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Participants in the discontinuation group (n = 94) had a higher endpoint score (5.8 (SD 3.0)) on the COVI Anxiety Scale than participants in the continuation group (n = 109) (4.7 (SD 2.4); P = 0.003), favouring continuation of long-term antidepressants.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.6.1 Anxiety symptoms measured with other scales
What the sources say
- Not checked — no full text of the sourcecites Terra 1998 source
plaincorrelationaln = 94 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Abrupt discontinuation increased the risk of relapse (as defined by study authors) (HR 1.97, 95% confidence interval (CI) 1.56 to 2.50; 1555 participants, 11 studies) compared to discontinuation, without specific assessment of withdrawal symptoms (Analysis 1.1).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.2.1 All studies (with and without psychological support)
plaindirectn = 1,555- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Study authors concluded that there were no significant differences in change scores on BAI nor on SQ Anxiety between groups (BAI -0.31 (SD 0.15) discontinuation (n = 16) and 0.4 (SD 0.64) antidepressant (n = 14) in treatment arms without CBT, and 0.66 (SD 2.04) discontinuation (n = 11) and -0.34 (SD 0.65) antidepressant (n = 11) in treatment arms with CBT; and SQ Anxiety 1.53 (SD 1.10) discontinu”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.6.1 Anxiety symptoms measured with other scales
What the sources say
- Not matchedcites Peterson 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“The DESS item most commonly reported as severe was trouble sleeping/insomnia (2.2% of participants in the discontinuation group and 4.2% 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) > 2.3.1 Types of withdrawal symptoms
What the sources say
- Not checked — no full text of the sourcecites Khan 2014 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Kocsis 2007 (n = 336) reported that one participant in the continuation group experienced suicidal thoughts; study authors considered this not related to treatment.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not checked — no full text of the sourcecites Kocsis 2007 source
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants in the discontinuation group reported lower scores on the QoL social functioning subscale (MD -6.44, 95% CI -12.10 to -0.77; 502 participants, 3 studies; I = 43%; a decrease in score indicates worsening, favouring continuation 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) > 2.7.1 Pooled studies
plaincorrelationaln = 502- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sensitivity analysis excluding these three studies did not substantially alter the metaanalysis result (OR 1.00, 95% CI 0.73 to 1.37).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“No suicide attempts during the trial were reported.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not checked — no full text of the sourcecites Kocsis 2007 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“and no difference in the SF-36 physical component summary score: 0.33 (SE 0.76) in the discontinuation group and -0.45 (SE 0.7) in the continuation group (P = 0.415).”
§ 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
- Not checked — no full text of the sourcecites Perahia 2009 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Keller 2007 (n = 83) reported that one (1/40) participant in the discontinuation group experienced suicidal ideation; study authors considered this possibly related to study treatment.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not checked — no full text of the sourcecites Keller 2007 source
plainconditionalSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Kuyken 2008 reported that at the end of the six-month window for tapering, 46 of 61 (75%) participants in the MBCT arm of the trial discontinued their medication.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Suicidal ideations were also reported by one participant in the discontinuation group.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not checked — no full text of the sourcecites Kocsis 2007 source
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Participants in the discontinuation group (n = 142) reported a higher score for Sheehan Disability Scale global functioning compared to those in the antidepressant group (n = 145) (mean change (SE) 2.06 (0.77) in the discontinuation group and -0.05 (0.71) in the antidepressant group; P = 0.029; increase in score signifies worsening).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.8.3 Social and occupational functioning as measured by other scales
What the sources say
- Not checked — no full text of the sourcecites Perahia 2009 source
plaincorrelationaln = 142 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“No other suicide-related events in the continuation group or in the discontinuation group were reported.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not checked — no full text of the sourcecites Keller 2007 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Perahia 2009 reported a difference in the SF-36 mental component summary mean change score, favouring continuation of antidepressant: -5.74 (SE 1.2) in the discontinuation group (n = 142) and -1.11 (SE 1.11) in the continuation group (n = 146) (P = 0.002)”
§ 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
- Not checked — no full text of the sourcecites Perahia 2009 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the pooled discontinuation group, participants reported significantly higher scores on the HAM-D scale compared to those in the antidepressant group (MD 3.50, 95% CI 2.31 to 4.68; 1017 participants, 6 studies; I = 29%).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.5.1 Pooled studies
plaincorrelationaln = 1,017- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the pooled discontinuation group, participants had higher scores on CGI-S compared to those in the pooled antidepressant group, favouring the antidepressant group (lower score indicates less impairment) (MD 0.61, 95% CI 0.44 to 0.79; 1187 participants, 6 studies; I = 29%).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.9.1 Pooled studies
plaincorrelationaln = 1,187- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“When this study was removed from the meta-analysis, the overall results did not change (OR 1.04, 95% CI 0.77 to 1.41).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.1 Pooled studies
What the sources say
- Not matchedcites Derubeis 2019
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and on the QoL emotional functioning subscale (MD -18.81, 95% CI -26.66 to -10.97; 502 participants, 3 studies; I = 0%; lower scores indicate impairment of functioning, favouring continuation of antidepressant) compared to participants 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) > 2.7.1 Pooled studies
plaincorrelationaln = 502- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Ten (16%) participants in the continuation group withdrew from the trial due to discontinuation 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) > 3.1 Successful discontinuation rate
What the sources say
- Not checked — no full text of the sourcecites Kuyken 2008 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants in the pooled discontinuation group (n = 257) showed higher scores on the HAM-A scale compared to those in the pooled antidepressant group (n = 269) (MD 3.53, 95% CI 1.92 to 5.14; 526 participants, 3 studies; I = 53%; higher score signifies more anxiety symptoms).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.6.1 Pooled studies
plaincorrelationaln = 526- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The difference between discontinuation and continuation groups was not significant (odds ratio (OR) 1.06, 95% CI 0.82 to 1.38; 1479 participants, 7 studies; I = 0%).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.1 Pooled studies
plainn = 1,479- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Perahia 2009 (n = 288) reported no suicide attempts.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.10 Suicide, suicide attempt, or suicidal ideation
What the sources say
- Not checked — no full text of the sourcecites Perahia 2009 source
plainn = 288- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the pooled discontinuation group, participants had higher total scores on the SAS-SR compared to participants in the pooled antidepressant group, favouring continuation of antidepressants (MD 0.19, 95% CI 0.11 to 0.28; 502 participants, 3 studies; I = 0%; lower scores indicate less impairment).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.8.1 Pooled studies
plaincorrelationaln = 502- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no differences between groups on the subscale quality of life (QoL) physical health problems (MD -2.08, 95% CI -5.66 to 1.49; 502 participants, 3 studies; I = 0%).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.7.1 Pooled studies
plainn = 502- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In the tapering advice group, 4 of 70 (6%; 95% CI 2 to 14) participants successfully stopped their antidepressant compared to 6 of 76 (8%; 95% CI 4 to 16) participants in the usual care group who spontaneously discontinued a er one year (Eveleigh 2018).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.1 Successful discontinuation rate
What the sources say
- Not matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No studies measured this outcome.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.6 Anxiety symptoms
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No studies measured this outcome.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.6 Anxiety symptoms
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In the tapering advice group, 18 of 70 (26%) participants relapsed compared to 10 of 76 (13%) in the usual care group (Eveleigh 2018).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.2 Relapse rate
What the sources say
- Not matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“There was no difference in quality of life between discontinuation with tailored recommendation and usual care (MD (with multiple imputation for missing values) -0.02, 95% CI -0.05 to 0.10; higher scores indicates better quality of life).”
§ 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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Study authors reported a higher mean CESD score in the tapering group (n = 51) (mean CESD total endpoint score 13.7 (SD 8.9)) compared to the usual care group (n = 55) (mean CESD total endpoint score 12.6 (SD 7.9)) at the end of the trial but no differences between groups (P = 0.51)”
§ 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
What the sources say
- Not matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 51- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and for depressive disorder HR 2.62 (95% CI 2.01 to 3.42).”
§ 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 5.1 Analysis 6.1 and Analysis 7.1.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Participants in the tapering advice (n = 70) group had a mean of 0.70 QALYs (SD 0.25), and in the usual care group (n = 76) a mean of 0.72 QALYs (SD 0.26).”
§ 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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 70- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Of the 36 (51%) participants who agreed to try, only 4 (6%) successfully stopped 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) > 4.1 Successful discontinuation rate
What the sources say
- Not matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Of participants who continued their antidepressant, there was a nonstatistically significant higher relapse rate in the tapering advice group versus the usual care group (25% versus 11%; 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) > 4.2 Relapse rate
What the sources say
- Not matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“They also reported that of the 70 participants in the tapering group, 34 (49%) did not comply with the advice to stop their antidepressant medication.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.1 Successful discontinuation rate
What the sources say
- Not matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 70- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“No studies assessed this outcome.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.3 Withdrawal symptoms
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Study authors reported a higher mean PAS score in the tapering group (n = 50) (mean PAS 4.1 (SD 7.2)) compared to the usual care group (n = 51) (mean PAS 3.6 (SD 7.1)) at the end of the study but no differences between groups (P = 0.71)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.6 Anxiety symptoms
What the sources say
- Not matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 50- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
In the paper
“Kuyken 2008 (n = 123) reported that no serious adverse events were recorded through the oversight of the Trial Steering Committee.”
§ 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
- Not checked — no full text of the sourcecites Kuyken 2008 source
plainn = 123- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For the outcome relapse, the test for subgroup differences was significant only for the indication of antidepressant (P = 0.02; I = 81.7%).”
§ 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 5.1 Analysis 6.1 and Analysis 7.1.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The estimated effect for anxiety disorder was HR 7.06 (95% CI 3.22 to 15.52)”
§ 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 5.1 Analysis 6.1 and Analysis 7.1.
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“but may increase severity of depressive symptoms (6 studies) and anxiety symptoms (3 studies).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this review, we included 33 randomised controlled trials (RCTs) with 4995 participants prescribed antidepressants long term (24 weeks or longer).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > D I S C U S S I O N Summary of main results
plainn = 4,995- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirteen (39%) studies discontinued the antidepressant abruptly.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discontinuation rates in the discontinuation group varied widely: 40%, 59%, and 75% (3 studies; very low-certainty evidence).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with high-intensity psychological interventions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The predefined subgroup analysis based on age did not show a difference in relapse.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is insufficient evidence of its effect on the quality of life subdomain physical health problems (3 studies; very lowcertainty evidence)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discontinuation rates in the discontinuation group varied: 55% in the discontinuation group and 12% in the continuation group a er 15 months in one study; and 40% in the discontinuation group a er 6 months in the other study (2 studies; very low-certainty evidence).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Withdrawal symptoms were measured in only one study.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“or adverse events (7 studies)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“but may increase severity of depressive symptoms (6 studies) and anxiety symptoms (3 studies).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared to continuation of antidepressants, abrupt discontinuation may increase severity of illness (5 studies; very low-certainty evidence).”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and may have little or no effect on the quality of life subdomains psychological or physical or social functioning (2 studies; very low-certainty evidence) compared to continuation of long-term antidepressants.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with high-intensity psychological interventions
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Again, pooling was not possible for discontinuation rate due to insufficient reporting of data.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with high-intensity psychological interventions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“One subgroup analysis suggested that discontinuation of antidepressants prescribed for anxiety disorder leads to more relapse than when prescribed for depressive disorders.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is insufficient evidence of the effect of abrupt discontinuation with psychological support as a co-intervention on relapse compared to continuation of antidepressants (2 studies; very lowcertainty evidence).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discontinuation rates in the discontinuation group varied: 55% in the discontinuation group and 12% in the continuation group a er 15 months in one study; and 40% in the discontinuation group a er 6 months in the other study (2 studies; very low-certainty evidence).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Low study numbers prohibited sensitivity analysis based on tapering regimens longer than four weeks.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“None of the eligible studies in this comparison category reported withdrawal symptoms, anxiety symptoms, social and occupational functioning, or severity of illness.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with high-intensity psychological interventions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Insufficient data pooling of results for the discontinuation outcome was not possible for the two studies in which”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discontinuation with a letter to the GP may make little or no difference in relapse (1 study; low-certainty evidence), depressive symptoms (1 study; lowcertainty evidence), and anxiety (1 study; low-certainty evidence)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with minimal intervention to usual care
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Subgroup analyses based on type of antidepressant and duration of antidepressant did not show a difference.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Evidence about the effects of discontinuation on withdrawal symptoms (1 study) is very uncertain.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discontinuation with a letter to the GP may make little or no difference in relapse (1 study; low-certainty evidence), depressive symptoms (1 study; lowcertainty evidence), and anxiety (1 study; low-certainty evidence)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with minimal intervention to usual care
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discontinuation with a letter to the GP may make little or no difference in relapse (1 study; low-certainty evidence), depressive symptoms (1 study; lowcertainty evidence), and anxiety (1 study; low-certainty evidence)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with minimal intervention to usual care
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and may have little or no effect on quality of life (1 study; very lowcertainty evidence) compared to usual care.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with minimal intervention to usual care
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Discontinuation with a letter to the GP may make little or no difference in the discontinuation rate (1 study; low-certainty evidence).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with minimal intervention to usual care
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and may have little or no effect on the quality of life subdomains psychological or physical or social functioning (2 studies; very low-certainty evidence) compared to continuation of long-term antidepressants.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with high-intensity psychological interventions
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pooling was not possible for adverse events due to insufficient information (3 studies; very low-certainty evidence).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with high-intensity psychological interventions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Nor did any of the included studies 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) > Overall completeness and applicability of evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and may have little or no effect on the quality of life subdomains psychological or physical or social functioning (2 studies; very low-certainty evidence) compared to continuation of long-term antidepressants.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with high-intensity psychological interventions
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most tapering regimens lasted four weeks or less.”
- Also stated in: § Overall completeness and applicability of evidence · plain
“Nearly all tapering studies used a tapering schedule of four weeks or less.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Overall completeness and applicability of evidence · plain
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The four studies that included people prescribed antidepressants for anxiety differed in terms of study characteristics, type of anxiety disorder, and intervention.”
§ 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
plainn = 4- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Twenty-five included of the 33 studies focused on participants with recurrent depression.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Indirectness of evidence
plainn = 33- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Many study authors used one continuous scale measuring depressive symptoms (e.g.Hamilton Depression Rating Scale (HDRS), Montgomery-Åsberg Depression Rating Scale (MADRS)) to assess relapse, then dichotomised the outcome as a threshold value (e.g.HAM-D score > 17).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Few studies had a focus on de-prescribing longterm antidepressants.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Most of the studies in our review included participants in remission from severe depression with a history of more than two previous episodes.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only two studies provided sufficient information to assess successful discontinuation rate”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Limited information on the majority of our primary and secondary outcomes restricted investigation of the benefits and harms of discontinuing long-term antidepressant use.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, most studies included in our review had a limited duration of antidepressant treatment (between six and twelve months) before discontinuation.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We found the certainty of evidence for primary and secondary outcomes to be very low to low due to limitations in study design, indirectness, and imprecision.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Quality of the evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“A minimal intervention such as a letter with tapering advice sent to the GP was investigated in only one trial.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Some studies included dysthymia, chronic depression, or double depression.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Indirectness of evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Overall, data on discontinuation either were not reported or were insufficiently reported.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Nearly all studies were designed to examine how continuation of long-term antidepressants could avoid relapse and recurrence rather than discontinuation success.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“None of the included studies used an active placebo that mimics side effects of antidepressants (e.g.drugs with anticholinergic actions, such as atropine, mimic TCA side effects).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“we did not find any differences between subgroups on the basis of total duration of antidepressant use in the comparison tapering versus continuation”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Only a few studies reported blinding integrity.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Our review has been unable to demonstrate that the relapse rate in primary care is lower than in secondary care.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“In addition, most studies involved people with recurrent depression.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Relapse rather than discontinuation success was the primary outcome for the vast majority of studies eligible for inclusion 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) > A U T H O R S ' C O N C L U S I O N S Implications for practice
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“we did not find any difference between subgroups on the basis of total duration of antidepressant use”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.2 Adverse events 7 1012 Odds Ratio (M-H, Random, 95% CI) 1.11 [0.62, 1.99]”
§ 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
plainn = 1,012- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.1.2No co-intervention follow-up > 24 weeks 10 1373 Hazard Ratio (IV, Random, 95% CI) 2.09 [1.59, 2.74]”
§ 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
plaincorrelationaln = 1,373- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.1.1All studies 11 1555 Hazard Ratio (IV, Random, 95% CI) 1.97 [1.56, 2.50]”
§ 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
plaincorrelationaln = 1,555- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.1.3With co-intervention follow-up > 24 weeks 2 182 Hazard Ratio (IV, Random, 95% CI) 1.48 [0.93, 2.34]”
§ 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
plainn = 182- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We identified one RCT that compared tapering with CBT to tapering without CBT for people with a remitted anxiety disorder.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.4.1 CGI-S total score 2 343 Mean Difference (IV, Random, 95% CI) 0.60 [0.27, 0.93]”
§ 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
plaincorrelationaln = 343- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.3.2HAM-D mean change 2 190 Mean Difference (IV, Random, 95% CI) -0.11 [-1.54, 1.32]”
§ 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
plainn = 190- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.4 Severity of illness 5 714 Mean Difference (IV, Random, 95% CI) 0.31 [0.13, 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) > Additional information
plaincorrelationaln = 714- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.4.2CGI-S mean change 3 371 Mean Difference (IV, Random, 95% CI) 0.24 [0.05, 0.43]”
§ 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
plaincorrelationaln = 371- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the included studies, authors reported relapse as time to events by using a hazard ratio (time-to-event data).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.3 Depressive symptoms 3 330 Mean Difference (IV, Random, 95% CI) 0.44 [-1.12, 2.00]”
§ 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
plainn = 330- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Data could not be pooled due to insufficient data reported”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Moreover, evidence showed no association between relapse rates and duration of treatment (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 checked — no full text of the sourcecites Geddes 2003 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Studies did not distinguish relapse from 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) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“and there was no evidence to justify the defined clinical distinction between continuation treatment (six to nine months) and maintenance treatment (two years or longer; 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 matchedcites Kaymaz 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“Evidence suggests that continuation of antidepressant treatment is effective, as it reduces risk of relapse and recurrence by 50% to 70% (Geddes 2003;Glue 2010;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
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“These findings suggest that cognitive therapy and MBCT in combination with discontinuation of antidepressants are potential alternatives to antidepressants for preventing relapse or recurrence.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Overall, strong evidence indicating whether long-term antidepressants can be discontinued effectively and safely is lacking.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“The effectiveness of interventions aimed at discontinuation of long-term antidepressant use is unknown.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Due to lack of evidence for the optimal duration of continuation and maintenance treatment, most guidelines are based on expert opinion.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Therefore we judged not measuring withdrawal symptoms as introducing a large source of bias.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms are a fundamental outcome in drug discontinuation trials.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, withdrawal confounding bias) and by one level for indirectness (three studies included participants with panic disorder; the other studies included recurrent depression or chronic depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.1.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, withdrawal confounding bias) and by one level for indirectness (3 studies included participants with panic disorder; the other studies included participants with recurrent depression or chronic depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.2.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, attrition bias, and withdrawal confounding bias; CGI-S rating of the clinician may be influenced by withdrawal symptoms, which include psychological symptoms and may worsen participants' condition) and by one level for indirectness (nearly”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.9.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms including psychological symptoms may impair severity of illness.
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 very low, downgraded by one level for imprecision (no meta-analysis), by one level for indirectness (studies included participants with recurrent depression in remission), and by one level for risk of bias (incomplete outcome reporting, withdrawal confounding bias).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by one level for imprecision (no pooling and small number of participants), by one level for risk of bias (confounding withdrawal bias, poor description of randomisation and blinding), and by one level for indirectness (only one of the three studies included participants with anxiety disorder (panic disorder)).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.6.1 Anxiety symptoms measured with other scales
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The HAM-A scale contains domain symptoms of psychic anxiety and somatic anxiety that are symptoms of withdrawal.
- Rests on an assumption: The COVI Anxiety Scale may register anxiety and other symptoms of withdrawal.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, withdrawal confounding bias) and by one level for indirectness (3 studies included participants with panic disorder; the other studies included participants with recurrent depression or chronic depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.2.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“None of these studies assessed 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) > 2.2.3 Studies with co-intervention
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, withdrawal confounding bias) and by one level for indirectness (three studies included participants with panic disorder; the other studies included recurrent depression or chronic depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.1.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by one level due to imprecision (single study included a small number of participants), by one level for risk of bias (randomisation and blinding were poorly described, severity of withdrawal symptoms was not scored in the outcome, and the period for observing withdrawal symptoms was relatively short), and by one level”
§ 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 Withdrawal symptoms
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“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 Valuck 2009 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by one level for risk of bias (poor description of randomisation and blinding), high risk of attrition bias, and withdrawal confounding bias (withdrawal symptoms may be misdiagnosed as adverse events), by one level for imprecision (wide 95% confidence interval, which includes the null effect of no difference), and by”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, and withdrawal confounding bias) and by one level for indirectness (majority of participants had recurrent depression, and one study included panic disorder).”
- Also stated in: § See Analysis 1.1. · plain
“We assessed the certainty of evidence for this outcome as very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, and withdrawal confounding bias) and by one level for indirectness (majority of participants had recurrent depression, and one study included panic disorder).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.2.1 All studies (with and without psychological support)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § See Analysis 1.1. · plain
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
“None of these studies measured withdrawal symptoms separately nor made adjustments for withdrawal.”
§ 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 Relapse rate (as defined by study authors)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 the outcome as very low, downgraded by one level for risk of bias (poor description of randomisation process and blinding, and withdrawal confounding bias), by one level for imprecision (small number of studies, small number of participants, and wide 95% confidence interval, which includes the null effect of no difference), and by one level for indirectness (studies in”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.2.3 Studies with psychological support as co-intervention
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by one level for risk of bias (poor description of randomisation and blinding, attrition bias, and withdrawal confounding bias), by one level for imprecision (wide 95% confidence interval, which includes the null effect of no differences between treatments), and by one level for indirectness (participants with recurrent”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.5.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The HAM-D scale contains domains that are symptoms of withdrawal.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, withdrawal confounding bias) and by one level for indirectness (three studies included participants with panic disorder; the other studies included recurrent depression or chronic depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.1.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, withdrawal confounding bias) and by one level for indirectness (3 studies included participants with panic disorder; the other studies included participants with recurrent depression or chronic depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.2.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of blinding of outcome assessors, attrition bias, and withdrawal confounding bias) and by one level for indirectness (studies included participants with recurrent or chronic/double depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.8.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may influence social and occupational functioning.
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 very low, downgraded by two levels for risk of bias (poor description of blinding of outcome assessors, attrition bias, and withdrawal confounding bias) and by one level for indirectness (studies included participants with recurrent or chronic/double depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.8.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of blinding of outcome assessors, attrition bias, and withdrawal confounding bias) and by one level for indirectness (studies included participants with recurrent or chronic/double depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.8.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
- Rests on an assumption: Withdrawal symptoms including psychological symptoms may impair the severity of illness.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and binding, attrition bias, and confounding withdrawal bias) and by one level for indirectness (two studies included participants with generalised anxiety disorder; one study included recurrent depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.6.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of blinding of outcome assessors, attrition bias, and withdrawal confounding bias) and by one level for indirectness (studies included participants with recurrent or chronic/double depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.8.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of blinding of outcome assessors, attrition bias, and withdrawal confounding bias) and by one level for indirectness (studies included participants with recurrent or chronic/double depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.8.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of blinding of outcome assessors, attrition bias, and withdrawal confounding bias) and by one level for indirectness (studies included participants with recurrent or chronic/double depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.8.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“All four studies included participants with recurrent depression in remission.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Comparison 3. Discontinuation with high-intensity psychological support versus continuation of long-term antidepressants (or usual care)
plainn = 4- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 the three QoL subdomains as very low, downgraded by one level for risk of bias (poor description of blinding outcome assessors, attrition bias, and withdrawal confounding bias; withdrawal symptoms may impair QoL measures) and by one level for indirectness (studies included participants with recurrent depression or chronic/double depression) and imprecision”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.7.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, high risk of attrition bias, confounding withdrawal bias; withdrawal symptoms may be misdiagnosed as adverse events) and by one level for indirectness (three studies reported only serious adverse events).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and binding, attrition bias, and confounding withdrawal bias) and by one level for indirectness (two studies included participants with generalised anxiety disorder; one study included recurrent depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.6.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: HAM-A scales contain symptoms from domains of psychic anxiety and somatic anxiety, all of which are symptoms of withdrawal.
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 the three QoL subdomains as very low, downgraded by one level for risk of bias (poor description of blinding outcome assessors, attrition bias, and withdrawal confounding bias; withdrawal symptoms may impair QoL measures) and by one level for indirectness (studies included participants with recurrent depression or chronic/double depression) and imprecision”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.7.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by one level for bias (withdrawal confounding bias) and by one level for imprecision (no pooling due to insufficient information) and indirectness (studies included participants with recurrent depression in remission).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, high risk of attrition bias, confounding withdrawal bias; withdrawal symptoms may be misdiagnosed as adverse events) and by one level for indirectness (three studies reported only serious adverse events).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misdiagnosed as adverse events.
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 the three QoL subdomains as very low, downgraded by one level for risk of bias (poor description of blinding outcome assessors, attrition bias, and withdrawal confounding bias; withdrawal symptoms may impair QoL measures) and by one level for indirectness (studies included participants with recurrent depression or chronic/double depression) and imprecision”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.7.1 Pooled studies
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may impair quality of life measures.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and binding, attrition bias, and confounding withdrawal bias) and by one level for indirectness (two studies included participants with generalised anxiety disorder; one study included recurrent depression).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.6.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 very low, downgraded by two levels for risk of bias (poor description of randomisation and blinding, high risk of attrition bias, confounding withdrawal bias; withdrawal symptoms may be misdiagnosed as adverse events) and by one level for indirectness (three studies reported only serious adverse events).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 for withdrawal confounding bias (study measured DESS symptoms but did not analyse data) and by one level for imprecision (single study had a small number of participants).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 4.2 Relapse rate
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
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 very low, downgraded by one level for imprecision (single study with a small number of participants) and by two levels for risk of bias (withdrawal confounding bias, large number of missing values, risk of performance bias).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
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 very low, downgraded by one level for risk of bias (withdrawal confounding bias; adverse events may include withdrawal symptoms), by one level for imprecision (no meta-analysis possible; low numbers of events and insufficient data supported study authors' conclusions), and by one level for indirectness (studies measured only serious adverse”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Adverse events may include withdrawal symptoms.
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 for imprecision (single study with a small number of participants) and by one level for risk of bias (withdrawal confounding bias; withdrawal symptoms may be misclassified as relapse and this may lead to restart of 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) > 4.1 Successful discontinuation rate
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
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) and by one level due to indirectness (studies included recurrent depressive disorder).”
§ 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.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
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 quality of life as very low, downgraded by one level due to risk of bias (withdrawal confounding bias, attrition bias, performance bias; outcome assessed with self-report questionnaire and likely to be influenced by lack of blinding of participants), by one level due to imprecision (wide 95% confidence interval includes the null effect), and by one level”
§ 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 3.3.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
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 for bias (risk of withdrawal confounding bias; studies did not use very slow tapering regimens or low doses) and by one level for indirectness (studies included participants with recurrent depression in remission).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.2.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
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
“Despite inclusion of 10 studies in the meta-analysis, we were unable to perform subgroup analysis for setting, disorder, type of antidepressant, or duration of antidepressant treatment due to unevenly distributed covariates”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation abrupt versus continuation of long-term antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Withdrawal symptoms may be misclassified as relapse and this may lead to restart of the antidepressant.
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 could not perform sensitivity analysis to assess the potential impact of a tapering regimen of four weeks or less because none of the studies (without co-intervention) reported a tapering regimen longer than four weeks.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of long-term antidepressants
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Consequently, it is unclear to what degree misclassified withdrawal symptoms contributed 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
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“It is therefore not possible for our review to draw conclusions about the best way to taper antidepressants.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“This approach may be of particular benefit for those unable to tolerate 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) > Overall completeness and applicability of evidence
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 could not perform sensitivity analysis for depressive symptoms or severity of illness because all included studies had noncommercial sponsorship or failed to report the source of funding.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation abrupt versus continuation of long-term antidepressants
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Moreover, withdrawal symptoms may have an effect on almost every outcome including adverse events, quality of life, social functioning, severity of illness, and anxiety and depression scores.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“First, in our review, we did not compare abrupt discontinuation with”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Withdrawal symptoms may be misdiagnosed as relapse, known as”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 could not perform sensitivity analysis for adverse events, depressive symptoms, anxiety symptoms, quality of life, social functioning, or severity of illness because all studies had non-commercial sponsorship or failed to report the source of funding.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of long-term antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“None of the studies distinguished relapse from symptoms of withdrawal.”
- Also stated in: § Discontinuation with high-intensity psychological interventions · plain
“but none of the studies distinguished relapse from symptoms of withdrawal.”
- Also stated in: § Overall completeness and applicability of evidence · plain
“the finding that trials did not distinguish relapse from 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) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Discontinuation with high-intensity psychological interventions · plain
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
“Thirty-two studies were assessed as having high risk of bias due to selective reporting.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Given that such factors may influence the benefits and harms of long-term antidepressant use, this limits the applicability of review results to clinical practice.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Therefore, we were not able to draw conclusions about whether it is effective and safe to discontinue long-term antidepressant use for patients with anxiety disorders.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Overall, blinding was poorly described.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Limitations in study design or execution
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“This review illustrates that initiation of high-intensity interventions such as PCT and MBCT may support discontinuation in patients with recurrent depression (very-low certainty of evidence)”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Applicability of the evidence in clinical practice is limited because most studies recruited participants from specialist outpatient mental healthcare settings.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Many depressive episodes (50% to 80%) treated in primary care are self-limiting within three to twelve months (6 studies) (Ormel 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 matchedcites Ormel 2020
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
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
“Use of different definitions of relapse, evaluated at different time points, compounds the difficulty and further limits generalisability.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“All studies had methodological limitations and were judged to be at unclear or high risk of bias in at least one domain.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Limitations in study design or execution
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Systematic research into possible benefits and harms related to antidepressant discontinuation has been a low priority for both researchers and the pharmaceutical industry (Hengartner 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
- Not matchedcites Hengartner 2019
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
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
“Eight studies were assessed as having high risk of performance bias due to lack of blinding of participants and/or research staff.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Limitations in study design or execution
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 included only one study with discontinuation combined with a minimal intervention; therefore we downgraded the evidence for all outcomes by one level for imprecision.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Imprecision
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“In more than half of the studies, information on random sequence generation or allocation concealment, or both, was insufficient”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Limitations in study design or execution
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“For those primary outcomes for which we had more than 10 studies, a funnel plot showed low risk of publication bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Publication bias
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Relapse, one of our primary outcomes, was based on the criteria defined by study authors and may be a source of potential bias for several reasons.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“For most outcomes, we did not downgrade for imprecision, as the sample was sufficiently large to detect a statistically significant difference between treatment groups.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Imprecision
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 two studies as having high risk of detection bias due to lack of blinding in outcome assessment.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Limitations in study design or execution
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“More than half of the studies were assessed as having high risk for attrition bias due to missing data, high dropout or unbalanced dropouts.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Limitations in study design or execution
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Consequently, the effect of discontinuation on person-centred outcomes is unknown.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Because of this, we downgraded the evidence by one level for indirectness.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Indirectness of evidence
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“There was significant variability across studies in terms of participant characteristics; antidepressant type, dosage, and duration; inclusion criteria (severity of depression, remission criteria); exclusion criteria; interventions; duration of tapering; and outcomes, making it difficult to interpret the pooled result.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Our review therefore cannot be generalised to patients seen in primary care with low risk of relapse.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Failure to measure withdrawal symptoms was assessed as a considerable source of bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A recent review of observational studies found worse long-term outcomes for patients with depression who are managed in specialist settings compared to those managed in primary care (5 studies) (Ormel 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 matchedcites Ormel 2020
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
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
“Based on available evidence, it is not possible to confidently determine the effectiveness and safety of the approaches to discontinuing antidepressant medication.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“However, we pooled studies with and without psychological support for our secondary outcomes, and this may be a source of potential bias.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Due to the small number of studies involving psychological therapy or minimal intervention to support discontinuation, we were unable to undertake all planned subgroup and sensitivity analyses.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Systematic research into possible benefits and harms related to antidepressant discontinuation has been a low priority for both researchers and the pharmaceutical industry (Hengartner 2019).”
§ 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 matchedcites Hengartner 2019
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
None of the sources cited for this claim have been checked yet.
In the paper
“In sum, the categories of treatment for one episode for six to nine months, or for more than two episodes for longer than two years, were 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) > Agreements and disagreements with other studies or reviews
What the sources say
- Not checked — no full text of the sourcecites Geddes 2003 source
- Not matchedcites Kaymaz 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“it is unclear how long antidepressant treatment has to be maintained a er remission”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“This may explain why we did not find a difference between abrupt discontinuation and (rapid) tapering.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Yet, it remains difficult to distinguish relapse from withdrawal with certainty.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“The last observation carried forward (LOCF) method was considered inappropriate for imputation, as it may lead to bias and overestimation (Woolley 2009).”
§ 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 Woolley 2009 source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Sensitivity analyses excluding studies at high risk of bias could not be performed because all studies were assessed as having high risk in at least one risk of bias domain.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“However, we were not able to perform the sensitivity analysis for all outcomes and comparisons due to few studies with low risk of industry sponsorship.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“the lack of distinction between withdrawal symptoms and relapse in the studies reviewed limits interpretation about the effectiveness and safety of approaches for stopping versus continuing long-term antidepressants.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Available evidence is insufficient to underpin conclusions for the important group of people taking antidepressants in the community (i.e.those with only one or no prior episode of depression, those aged 65 years and older, or those taking antidepressants for anxiety).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“It remains unclear how long antidepressant treatment has to be maintained a er remission”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: 25% (28/110) placebo and 18% (20/104) milnacipran patients discontinued for reasons other than relapse; reasons not stated”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In another study (n = 56) with paroxetine, participants who tapered their paroxetine over an average duration of 38.6 weeks (range 2 to 197 weeks), titrated to the individual, had a 6.1% incidence of withdrawal syndrome, compared with 78.2% for abrupt discontinuation (Murata 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 Murata 2010 source
plaindirectn = 56- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“much higher dropout rate in discontinuation group (41/70) than in antidepressant group (21/70)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: no placebo used; not double-blind”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: adverse events were reported; withdrawal symptoms 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) > Additional information
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: the study report fails to include results for adverse events and withdrawal symptoms that would be expected to have been reported for such a study”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“dropout was higher in discontinuation group (n = 20/70; 28%) compared to continuation group (n = 10/76; 13%)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plaindirectn = 20- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: higher dropout rate in placebo group (50.6%) than in sertraline group (31.5%); last observation carried forward ('LCOF') analyses”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: dropout rates were higher in the placebo group (76%) than in the venlafaxine group (50%); LOCF analysis”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: the study report fails to include results for adverse events and withdrawal symptoms that would be expected to have been reported for such a study”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In one study (n = 74), participants who tapered their SSRI dose over a period of up to four months had significantly fewer withdrawal symptoms compared to patients who discontinued abruptly (van Geffen 2005).”
§ 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 van Geffen 2005 source
plaindirectn = 74- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: high rate of missing data (69/142 (48%) placebo group, 50/146 (34%) duloxetine group); although reasons reported, still high dropout”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“the withdrawal rate is much higher in the placebo group (61.9%) compared to the nefazodone group (38.2%)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: neither withdrawal symptoms nor adverse events were reported.Other bias Unclear risk Source of funding was not reported”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: dropouts not reported”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: dropout rates high and not balanced across groups: 14/54 (25%) dropouts in placebo group and 18/82 (21%) dropouts in antidepressant group.Reasons for dropout reported”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Time-to-event outcomes are most appropriately analysed using hazard ratios (HRs), which take into account the number and timing of events and the time until last follow-up for each patient who has not experienced an event (i.e. has been censored) (Tierney 2007).”
§ 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
- Not matchedcites Tierney 2007
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Not matched
- 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
- Supportedcites Davies 2019 source
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)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
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 supportedcites Horowitz 2019 sourceExperimental — accuracy not yet measured
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)
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
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
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 matchedcites Nilsen 2012
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Partly supportedcites Fava 2015 sourceExperimental — accuracy not yet measured
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)
- Supportedcites Fava 2018b source
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)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
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 supportedcites Huijbers 2016 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
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 supportedcites Huijbers 2016 sourceExperimental — accuracy not yet measured
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)
plainn = 128- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
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 verifycites Bockting 2018 sourceExperimental — accuracy not yet measured
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)
plainn = 42- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
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
- Supportedcites Bockting 2018 source
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Supported
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 supportedcites Kuyken 2015 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
- Partly supported
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 supportedcites Bockting 2018 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plainn = 185- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
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
- Supportedcites Kuyken 2015 source
Split into 2 atoms — 2 confirmed, 0 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plainn = 424- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
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
plain- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
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
- Supportedcites Kuyken 2015 source
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 supportedcites Bockting 2018 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
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
- Supportedcites Davies 2019 sourceExperimental — accuracy not yet measured
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)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
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
- Supportedcites Horowitz 2019 source
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)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Supported
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
- Supportedcites Davies 2019 source
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)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
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 supportedcites Eaton 2008 sourceExperimental — accuracy not yet measured
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)
- Not checked — no full text of the sourcecites Mattisson 2007 source
- Not matchedcites Moffit 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
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
- Supportedcites Jakobsen 2017 source
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)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
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 supportedcites Johnson 2017 sourceExperimental — accuracy not yet measured
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
- Not matchedcites Pilgrim 1999
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites Ulfarson 2003
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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.
- Partly supported
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 supportedcites Johnson 2012 sourceExperimental — accuracy not yet measured
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)
- Not checked — no full text of the sourcecites Petty 2006 source
- Not matchedcites Kjosavik 2016
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
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
- Supportedcites Jakobsen 2017 source
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)
- Not checked — no full text of the sourcecites Kirsch 2007 source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 supportedcites Maund 2019 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
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
- Supportedcites Duffy 2019 source
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)
- Not matchedcites ISRCTN12417565
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Supported
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 supportedcites Bergh 2012 sourceExperimental — accuracy not yet measured
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)
- Not matchedcites Ulfarson 2003
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
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
- Supportedcites Pigott 2015 source
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)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Supportedcites Johnson 2012 source
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)
- Partly supportedcites Maund 2019 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
- Not matched
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 supportedcites Maund 2019 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
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
- Supportedcites Batelaan 2017 source
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)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
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 matchedcites Maund 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Partly supportedcites Scholten 2020 sourceExperimental — accuracy not yet measured
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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
- Supportedcites Batelaan 2017 source
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)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
- Supported
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
- Supportedcites Maund 2019 source
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
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 supportedcites Moncrieff 2004 sourceExperimental — accuracy not yet measured
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)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
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
- Supportedcites Horowitz 2019 source
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Supported
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 supportedcites Groot 2020 sourceExperimental — accuracy not yet measured
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)
plainn = 895- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 supportedcites Maund 2019 sourceExperimental — accuracy not yet measured
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)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
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
- Supportedcites Horowitz 2019 source
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)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
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
- Supportedcites Wilson 2015 source
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
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
- Supportedcites Voshaar 2006 source
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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 13 studies, the antidepressant was stopped abruptly; in 18 studies, the antidepressant was stopped gradually over several weeks (”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Withdrawal symptoms None of the studies reported withdrawal”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Bockting 2018 (n= 185; split 143) reported only suicide data.There were 2 suicide attempts (1 in the PCT with tapering group and 1 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) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Adverse events 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) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most people in these studies had recurrent depression (two or more episodes of depression before stopping antidepressants), and most were recruited from specialist mental healthcare services.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Kuyken 2015 (n = 424) reported 3 non-fatal and 2 fatal serious adverse events (deaths) in each treatment group, and 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) > Study characteristics
hedgedn = 424- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most tapering schemes lasted four weeks or less.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“One study measured withdrawal symptoms but did not analyse or report data”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our search up until January 2020 found 33 studies, which included 4995 adult participants.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plainn = 4,995- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Adverse events 3 studies reported no differences in adverse events 690 (3 RCTs) ⊕⊝⊝ ⊝ VERY LOW d”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Kuyken 2008 (n = 123) reported that no serious adverse events were recorded through the oversight of the Trial Steering Committee.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study characteristics
plainn = 123- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All studies included more female than male participants, except one study that included only males”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sample size
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Eleven studies were published in 2000 or earlier.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Study authors described 21 studies as multi-centre studies”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Setting
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Four studies included only participants 65 years of age and older”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sample size
plainn = 4- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The antidepressant is discontinued by”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" without psychological support (or psychological support as co-intervention)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Randomised participants represent a small fraction of participants in the pre-randomisation phase.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Participants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We identified one unpublished study for which data were obtained from clinicaltrials.govand a conference abstract (Streim 2012).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Three types of studies were included.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Aims of studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sample size varied from 11 in Mavissakalian 2001 to 336 participants in Kocsis 2007 (average, 151).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sample size
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean age of participants ranged from 36 years in Mavissakalian 1999 to 76 years in Wilson 2003.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sample size
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Twenty-two studies included participants with the main diagnosis of recurrent major depressive disorder”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Participants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Trials evaluated several regimens for antidepressant discontinuation including abrupt discontinuation, discontinuation by tapering, discontinuation by tapering combined with highintensity psychological treatment, and discontinuation by tapering combined with a minimum intervention.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“All studies compared discontinuation with continuation of antidepressants, except one study that compared discontinuation with usual care (Eveleigh 2018).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“13 studies discontinued during”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Five of the 33 studies included participants in partial remission.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Severity of depressive disorder/anxiety disorder at the moment of randomisation
plainn = 33- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Twenty-six studies included a placebo arm”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“four studies used a two-phase method (Kane 1982; Khan 2014; Mavissakalian 1999; Rickels 2010), 21 employed a three-phase method (Derubeis 2019;Gelenberg 2003;Gilaberte 2001;Keller 1998;Klysner 2002;Kocsis 1996;Kocsis 2007;Kornstein 2006;Kupfer 1992;Mavissakalian 2001;Montgomery 1988;Montgomery 2004;Perahia 2009;Peterson 2010;Rapaport 2001;Rickels 2010;Rouillon 2000;Segal 2010;Stewart 1997;Terra 1”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Studies investigating the effectiveness of an intervention designed to facilitate discontinuation of long-term antidepressants (five studies)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Aims of studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Studies with a psychological co-intervention (six studies)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Aims of studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the 33 included studies, 25 were conducted in a psychiatric outpatient setting.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Setting
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“None of these studies used an active placebo tablet.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“16 studies discontinued at the start of or during maintenance treatment”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In eight studies, participants discontinued (or tapered) the antidepressant and the antidepressant was not replaced by placebo (Bockting 2018;Derubeis 2019;Eveleigh 2018;Huijbers 2016;Kuyken 2008;Kuyken 2015;Segal 2010;Streim 2012).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Four studies included participants with anxiety disorder: three included participants with panic disorder with agoraphobia (Mavissakalian 1999; Mavissakalian 2001), or with or without agoraphobia (Rapaport 2001), and one included participants with generalised anxiety disorder (Rickels 2010).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Anxiety (4 studies)
plainn = 4- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Indication for antidepressant Depression (28 studies)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Participants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In four studies, duration of treatment a er stabilisation was not specified”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Fourteen studies investigated antidepressant discontinuation by”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" without psychological support (or psychological support as co-intervention)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Four studies were conducted in general practice/primary care settings”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Setting
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most studies included adults between 18 and 65 years of age.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sample size
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Most studies required that participants were in remission to enter the discontinuation trial and reported remission criteria.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Severity of depressive disorder/anxiety disorder at the moment of randomisation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Twenty-six studies included multiple treatment phases before randomisation to antidepressants or to placebo (”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirty-two studies were RCTs, and one was a cluster-RCT (Eveleigh 2018).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Design
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“None of the studies included discontinuation with changed pharmacological form (e.g.fluoxetine or paroxetine liquid) or a low-intensity psychological intervention.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Most studies excluded participants at high risk for suicide.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Social and occupational functioning
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This included 31 studies.”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We judged 12 studies with only non-commercial sponsorship to be at low risk for industry sponsorship (Bockting 2018;Eveleigh 2018;Huijbers 2016;Kane 1982;Kupfer 1992;Kuyken 2008;Kuyken 2015;Mavissakalian 1999;Mavissakalian 2001;Segal 2010;Stewart 1997;Streim 2012).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Included studies compared abrupt discontinuation with continuation of antidepressant treatment: eight studies used SSRI (Gilaberte 2001;Klysner 2002;Kornstein 2006;Montgomery 1988;Peterson 2010;Rapaport 2001;Terra 1998;Wilson 2003), one study TCA (Kane 1982), one study an atypical antidepressive (Gelenberg 2003), two studies SNRI (Khan 2014;Rouillon 2000), and one study a non-specified type of ant”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“One study investigated tapering with a recommendation to review the antidepressant to GP versus usual care”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation in combination with a minimal intervention
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In these eight studies, participants and/or clinicians were not blinded and were aware of the treatment, and the discontinued antidepressant was not replaced by a placebo.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Performance bias (blinding of participants and personnel)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Six studies used only DSM or research diagnostic criteria (RDC) for diagnosis of major depression: DSM-IV criteria were assessed with a structured clinical interview for DSM-IV Axis I Disorders (SCID-I), including retrospective parts and information from monthly ratings on the Inventory of Depressive Symptomatology-Self-Report (IDS-SR) (Bockting 2018).”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Two studies used only clinical judgement: appearance of a depressive episode as decided upon by the patient and by the blinded research clinician (Bialos 1982), as well as investigator's clinical assessment that change in pharmacological treatment was indicated (Cook 1986).”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We judged 12 studies to be at low risk of bias for this domain.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sequence generation
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Eight studies used nine different scales: HAM-A (Keller 2007; Kocsis 2007; Rapaport 2001; Rickels 2010); anxiety/somatisation subscale of the HAM-D scale (Perahia 2009); IDS-SR anxiety (Keller 2007; Kocsis 2007); BAI and SQ anxiety scores (Peterson 2010); Covi Anxiety Scale (Terra 1998); Panic and Agoraphobia Scale (PAS) (Eveleigh 2018); Hospital Anxiety and Depression Scale (HADS), anxiety factor”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“A total of 21 studies measured adverse events of antidepressants, but this outcome may be biased because it may include withdrawal symptoms as these studies did not distinguish withdrawal symptoms from adverse events 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) > Selective reporting
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All studies except two addressed relapse”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“All studies except two reported relapse using hazard ratios”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We deemed 12 studies to be at low risk of detection bias as they provided a clear description of the method of blinding of outcome assessors (Bialos 1982;Bockting 2018;Cook 1986;Derubeis 2019;Eveleigh 2018;Gelenberg 2003;Kupfer 1992;Kuyken 2008;Kuyken 2015;Segal 2010;Stewart 1997;Wilson 2003).”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We judged four studies to be at unclear risk as they did not report the reasons for dropout but dropout numbers were similar between groups or the number of dropouts was not clear from the text (Kane 1982;Montgomery 1988;Stewart 1997;Terra 1998).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Seven studies used a combination of DSM or RDC for major depression and scale measurements: HAM-D score ≥ 16 plus major depression (diagnosed on two consecutive visits via DSM-IV) (Gelenberg 2003); meeting DSM-III criteria for major depression with HAM-D score ≥ 18 and CGI-S score ≥ 4, or both of these, for at least two weeks (Gilaberte 2001);”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We judged 11 studies as having low risk of performance bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Performance bias (blinding of participants and personnel)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“All studies addressed at least one of our primary outcomes.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Outcome measures
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Study duration varied widely from 4 weeks to 156 weeks.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study duration
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Five studies used five different scales: Social Adjustment Scale Self-Report (SAR-SR) (Bialos 1982;Keller 1998;Keller 2007;Kocsis 2007), LIFE subject assessment, interviewer assessment, and satisfaction assessment (Keller 1998), and Sheehan Disability Scale (SDS) (Perahia 2009).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Social and occupational functioning
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nine studies used 18 different scales: Short Form (SF)-36 subscales of social functioning, role limitations due to emotional problems and to physical health problems (Keller 1998; Keller 2007; Kocsis 2007); SF-36 mental and physical component summary scores (Keller 2007; Kocsis 2007; Perahia 2009);”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Eleven studies contributed data for this outcome (Gelenberg 2003;Gilaberte 2001;Kane 1982;Klysner 2002;Kornstein 2006;Montgomery 1988;Peterson 2010;Rapaport 2001;Rouillon 2000;Terra 1998;Wilson 2003).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.2 Relapse (as defined by study authors)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Six studies used a combination of scale measurements and clinical judgement: HAM-D score > 12 and GAS score < 60 on three successive ratings over a period of four weeks, or at least one rating meeting these criteria, and urgent need for alternative treatment for a depressive syndrome (Kocsis 1996);”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Five other studies measured depressive symptoms by using the HAM-D scale but did not report data for each treatment group (Gelenberg 2003;Mavissakalian 1999;Mavissakalian 2001;Segal 2010;Stewart 1997).”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The source of funding was not described in four studies (Cook 1986;Montgomery 1988;Peterson 2010;Terra 1998).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Funding
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The primary outcomes successful discontinuation rate, relapse, and adverse events were not reported in 31 (94%), 2 (6%), and 12 (36%) trials.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Twelve studies reported only non-commercial sponsorship (Bockting 2018;Eveleigh 2018;Huijbers 2016;Kane 1982;Kupfer 1992;Kuyken 2008;Kuyken 2015;Mavissakalian 1999;Mavissakalian 2001;Segal 2010;Stewart 1997;Streim 2012).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Funding
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Seventeen studies were supported by a grant from the pharmaceutical industry (Bialos 1982;Derubeis 2019;Gelenberg 2003;Gilaberte 2001;Keller 1998;Keller 2007;Khan 2014;Klysner 2002;Kocsis 1996;Kocsis 2007;Kornstein 2006;Montgomery 2004;Perahia 2009;Rapaport 2001;Rickels 2010;Rouillon 2000;Wilson 2003).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Funding
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Five studies used only scale measurements: LIFE Rating Scale score of 5 or 6 for two consecutive weeks at any time a er the first eight weeks and for three consecutive weeks during the first eight weeks (Derubeis 2019), MADRS score ≥ 22 confirmed a er three to seven days (Klysner 2002), HAM-D score > 18 (Montgomery 1988), CGI-S score ≥ 4 (Montgomery 2004), and two consecutive weeks of a CGI rating”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The most common high-risk domain was reporting bias, followed by attrition bias.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“We judged no studies to be at risk for baseline imbalance.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A total of 17 studies used 10 different scales to measure depressive symptoms: HAM-D (Bialos 1982; Cook 1986; Gilaberte 2001; Keller 1998; Keller 2007; Kocsis 2007; Kornstein 2006; Kuyken 2008; Kuyken 2015; Montgomery 2004; Peterson 2010; Perahia 2009; Stewart 1997) and/or HAM-D subscale depressed mood item 1 score (Montgomery 2004; Perahia 2009), MADRS (Cook 1986; Keller 1998; Kornstein 2006;”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We assessed 19 studies as being at unclear risk; study authors did not specify whether outcome assessors were blinded or how they were blinded (Gilaberte 2001;Kane 1982;Keller 1998;Keller 2007;Khan 2014;Klysner 2002;Kocsis 2007;Kornstein 2006;Mavissakalian 1999;Mavissakalian 2001;Montgomery 1988;Montgomery 2004;Perahia 2009;Peterson 2010;Rapaport 2001;Rickels 2010;Rouillon 2000;Streim 2012;Terra 1”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A total of 21 studies reported serious adverse events and/or adverse events: Cook 1986; Bockting 2018; Derubeis 2019; Gelenberg 2003; Gilaberte 2001; Keller 1998; Keller 2007; Khan 2014; Klysner 2002; Kornstein 2006; Kocsis 2007; Kuyken 2008; Kuyken 2015; Montgomery 2004; Perahia 2009; Rapaport 2001; Rickels 2010; Rouillon 2000; Streim 2012; Terra 1998; Wilson 2003.”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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 matchedcites Catalogue of Bias 2019
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We excluded 78 studies from the review (see Characteristics of excluded studies).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The secondary outcomes depressive symptoms, anxiety symptoms, quality of life, social functioning, and severity of illness were not clearly reported in 16 (48%), 25 (76%), 24 (73%), 28 (85%), and 22 (67%) trials.”
§ 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
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We assessed 20 studies to be at high risk as a large proportion of data were missing and/or there was an imbalance in the number of missing participants across treatment groups (Bialos 1982;Derubeis 2019;Eveleigh 2018;Gelenberg 2003;Gilaberte 2001;Huijbers 2016;Keller 1998;Keller 2007;Klysner 2002;Kocsis 2007;Kornstein 2006;Mavissakalian 1999;Mavissakalian 2001;Montgomery 2004;Perahia 2009;Rap”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Seventeen studies reported relapse rate as an outcome (Bialos 1982;Bockting 2018;Cook 1986;Derubeis 2019;Huijbers 2016;Keller 1998;Keller 2007;Kocsis 1996;Kocsis 2007;Kupfer 1992;Mavissakalian 1999;Mavissakalian 2001;Montgomery 2004;Perahia 2009;Rickels 2010;Segal 2010;Stewart 1997).All but one -Cook 1986 -reported time to relapse by using hazard ratios.”
§ 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 Relapse rate (as defined by study authors)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“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
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plainSingle case- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plainn = 146- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“None of these studies measured separately symptoms of withdrawal nor attempted to make adjustments for them.”
§ 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)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Removing them from the analyses reduced statistical heterogeneity to 0%.This did not change the direction of the effect but reduced its magnitude (MD 0.44, 95% CI 0.30 to 0.57).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.9.1 Pooled studies
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plaindirectn = 94- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plainn = 160- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 matchedcites Streim 2012
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plainn = 13- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 matchedcites Streim 2012
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Removing these two studies from the analyses reduced statistical heterogeneity to 0%.This did not change the direction of effect but slightly increased the effect size (MD 0.64, 95% CI -0.27 to 1.54), favouring continuation of long-term antidepressant.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.5.1 Pooled studies
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plainn = 89- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The most common adverse events (≥ 10%) in the discontinuation group included headache, insomnia, dizziness, fatigue, dyspepsia, pain, asthenia, diarrhoea, upper respiratory infection, nausea, dizziness, vasodilatation, dry mouth, insomnia, sweating, nausea, nervousness, and paraesthesia.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.4.2 Types of adverse events
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plainn = 139- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plainn = 18- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For the outcome relapse, the test for subgroup differences for age was not statistically significant (age; P = 0.69; I = 0%).This suggests that there is no difference between participants based on age (younger than 65 years versus 65 years and older).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation abrupt versus continuation of long-term antidepressants
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“None of the included studies compared discontinuation with changed pharmacological form versus continuation 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) > Comparison 5. Discontinuation with psychosocial interventions versus continuation of long-term antidepressants versus continuation of long-term antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The remaining tests were not statistically significant (type of antidepressant (TCA versus SNRI): P = 0.48 (no SSRI subgroup due to only 1 study), I = 0%; duration of antidepressant (shorter than 52 weeks versus 52 weeks or longer: P = 0.36; I = 0%).”
§ 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 5.1 Analysis 6.1 and Analysis 7.1.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No studies measured this outcome.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 3.6 Anxiety symptoms
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“None of the studies compared discontinuation with low-intensity psychological interventions or a changed pharmacological form to continuation 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) > D I S C U S S I O N Summary of main results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of our four primary outcomes of interest, 2 studies addressed successful discontinuation rate, 31 addressed relapse, 1 withdrawal symptoms, and 21 adverse events.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > D I S C U S S I O N Summary of main results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The discontinuation rate was low, with 6% of participants discontinuing compared to 8% in the usual care group.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with minimal intervention to usual care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Withdrawal symptoms were measured a er tapering of antidepressants but were 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) > Discontinuation with minimal intervention to usual care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirteen studies (1780 participants) compared abrupt discontinuation to continuation of long-term antidepressants.Two of these studies included a psychological co-intervention (cognitive-behavioural therapy (CBT) and cognitive-behavioural analysis system of psychotherapy (CBASP)) in both treatment groups.”
§ 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
plainn = 1,780- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Subgroup analyses based on age and setting was not possible.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sensitivity analyses excluding six studies (with funding from industry or an unknown source of funding) made confidence intervals substantially wider but did not change the direction of the effect (OR 1.14, 95% CI 0.09 to 13.97).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation abrupt versus continuation of long-term antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — 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 discontinuation by”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“None of the eligible studies in this comparison reported the antidepressant discontinuation rate or either of the patient-centred outcomes quality of life and social and occupational functioning.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Discontinuation by”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
plain- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
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.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The study did not report adverse events, social and occupational functioning, or severity of illness.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation with minimal intervention to usual care
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — 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”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
hedgedconditional- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
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. The quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“very low-certainty evidence suggests that”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of longterm antidepressants
hedged- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
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.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sensitivity analyses excluding these nine studies reduced substantially the magnitude of the treatment effect, and the confidence interval included the null effect (HR 1.20, 95% CI 0.84 to 1.71).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation abrupt versus continuation of long-term antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pooling data on anxiety symptoms was not possible due to heterogeneity in measures (3 studies; very low-certainty evidence).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There is insufficient evidence of its effect on adverse events (7 studies; very low certainty evidence) and depressive symptoms (3 studies).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sensitivity analyses excluding these 9 studies did not change the direction of the effect but increased the magnitude of the treatment effect and made the confidence interval wider (HR 3.36, 95% CI 1.58 to 7.16).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation by "tapering" versus continuation of long-term antidepressants
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Additionally no studies have systematically reported other medication use (e.g.chronic psychoactive medication) and psychotherapy at baseline or at trial initiation, and few have examined other psychiatric disorders or non-psychiatric disorders (if not excluded).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Studies in people aged 65 years and older are sparse (3 studies), indicating a gap in the evidence.”
§ 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
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“One study included a tapering schedule determined by clinician and patient together but poorly described the discontinuation and tapering process.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As all studies captured in our review used commercially available formulations of antidepressants, no study included a slow tapering regimen with very low doses over some months or a changed pharmacological form such as liquid or tapering strips (to allow low doses 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) > Overall completeness and applicability of evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“As described in the Background section of this review, there are other methods to support discontinuation that were not captured here.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 matchedcites Eiring 2015
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Overall, the dropout rate in these studies was high.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most tapering regimens in the included studies were limited to four weeks or less, which makes them very similar to rapid discontinuation regimens.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Moreover, few studies reported data on suicide, and none of the study authors assessed suicide, suicide attempt, or suicidal ideation related to the medication.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most (60%) individuals tapered antidepressants with their doctors over 6 months”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.3.1 HAM-D total score endpoint 1 140 Mean Difference (IV, Random, 95% CI) 3.40 [0.42, 6.38]”
§ 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
plaincorrelationaln = 140- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
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 matchedcites APA 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites CANMAT 2016
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites Declercq 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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 matchedcites Kaymaz 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
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 matchedcites APA 2010
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not matchedcites CANMAT 2016
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites Geddes 2003 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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 matchedcites Aroll 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
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
“Discontinuation of antidepressants may decrease risk of adverse events and risk of drug-drug interactions and may minimise the number of medicines, whilst making no difference in depressive and anxiety symptoms.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > How the intervention might work
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. 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 contacted trial authors and subject experts for information on unpublished or ongoing trials, or to request additional trial data.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Correspondence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 calculated the proportion lost to follow-up for each group and reported this.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Dealing with missing data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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) > Sensitivity analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Two review authors (EVL, LR) independently extracted trial characteristics and outcome data from 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) > Data extraction and management
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 performed additional sensitivity analyses to test the impact of industry sponsorship by excluding trials with industry sponsorship or with an unclear source of funding 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) > Sensitivity analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“However, discontinuation might cause withdrawal symptoms and recurrence or worsening of the original depressive or anxiety symptoms, which contributes to unsuccessful discontinuation.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > How the intervention might work
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. 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 searched international trials registries via the World Health Organization trials portal (ICTRP) and ClinicalTrials.gov to identify unpublished or ongoing trials.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Timing of outcome assessment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 checked the reference lists of all included trials and relevant systematic reviews to identify additional trials missed during the original electronic searches (e.g.unpublished citations, in-press citations).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Reference lists
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 used a data collection form that we had piloted on at least one trial in the review, to extract trial characteristics and outcome data.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Data extraction and management
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“When considering treatment effects, we took into account the risk of bias for trials that contributed to that outcome.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Data extraction and management
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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 evidence as high, moderate, low, or very low certainty, depending on the seriousness of concern about risk of bias, imprecision, inconsistency, indirectness, and publication bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Summary of findings and assessment of the certainty of the evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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
“Three review authors (EVL, MVD, TC) used the GRADE approach independently to assess evidence certainty for all outcomes.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Summary of findings and assessment of the certainty of the evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 investigated potential publication bias by using a funnel plot when at least 10 trials met the inclusion criteria of the review.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Assessment of reporting biases
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“When possible, we carried out an intention-to-treat (ITT) analysis for all outcomes.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Dealing with missing data
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 carried out sensitivity analysis to assess the impact on the effect estimate of trials with high risk of bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sensitivity analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 extracted the intraclass correlation coefficient (ICC) for each trial.We adjusted for the clustering effect by dividing the clusters by a 'design effect'.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cluster-randomised trials
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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 resolved disagreements by reaching consensus or by involving a third review author (MVD).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Data extraction and management
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 each potential source of bias as high, low, or unclear and provided a supporting quote from the trial report together with a justification for our judgement in the 'Risk of bias' table.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Data extraction and management
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 resolved any disagreements through discussion, or, if required, we consulted a third review author (MVD).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 retrieved full-text trial reports and publications, and two review authors (EVL, MD) independently screened the full text, identified trials for inclusion, and identified and recorded reasons for exclusion of ineligible trials.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
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
“Low-intensity psychological or psychosocial interventions have the potential to reach more people.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
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 a complete-case analysis and included in the analysis only participants with a recorded outcome.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Dealing with missing data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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
“It is important to note that the majority of relapse prevention discontinuation trials did not distinguish relapse from symptoms of withdrawal a er discontinuation; this is a confounder that makes study findings difficult to interpret.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 identified and excluded duplicate records, and we collated multiple reports that relate to the same trial, so that each trial rather than each report was the unit of interest in the review.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. 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 did not make any assumptions about loss to follow-up for dichotomous or continuous data.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Dealing with missing data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 summarised risk of bias judgements across different trials for each of the domains listed.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Data extraction and management
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“If ICCs were not reported, we requested them from trial authors.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cluster-randomised trials
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“To minimise risk of publication bias, we performed a comprehensive search of multiple databases, including searching for unpublished trials.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Assessment of reporting biases
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Two review authors (EVL, MD) independently screened titles and abstracts for inclusion of all potential trials identified as a result of the search and coded them as 'retrieve' (eligible or potentially eligible/unclear) or 'do not retrieve'.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 double-checked that data had been entered correctly by comparing data presented in the systematic review with data provided in trial reports.A second review author (LR) spot-checked trial characteristics for accuracy against the trial report.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Data extraction and management
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 searched the grey literature for dissertations and theses.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Grey literature
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 performed meta-analysis only when trials were sufficiently homogeneous in terms of participants, interventions, and outcomes.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Assessment of heterogeneity
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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 investigated heterogeneity by conducting pre-specified subgroup analyses, and we compared subgroups using the formal test for subgroup differences for primary outcomes.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Subgroup analysis and investigation of heterogeneity
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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 justified all decisions to downgrade the certainty of evidence in the footnotes of the 'Summary of findings' table.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Summary of findings and assessment of the certainty of the evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 did not apply any restrictions on date, language, or publication status to the searches.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Timing of outcome assessment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“All studies had to meet the main inclusion criterion that participants received long-term antidepressants (for at least 24 weeks) for depressive or anxiety disorder.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Participants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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 matchedcites Higgins 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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
“It is important to note that adverse events may include withdrawal symptoms, as these studies did not distinguish between adverse events and 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 1.2.
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 did not downgrade for attrition bias, as censoring for survival data is unlikely to introduce bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.1.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 did not downgrade for attrition bias, as censoring for survival data is unlikely to introduce bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.1.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 did not downgrade for attrition bias, as censoring for survival data is unlikely to introduce bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.2.1.1 Pooled studies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Neither of the studies assessed withdrawal symptoms; therefore withdrawal symptoms could be misclassified, and this may result in a restart of antidepressants due to intolerable 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) > 2.1.1 All studies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“None of these studies distinguished symptoms of relapse from symptoms of withdrawal 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) > 3.2 Relapse rate (as defined by study authors)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Three studies reported on discontinuation rate in the discontinuation group.None of these studies assessed 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) > 3.1 Successful discontinuation rate
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 were unable to perform subgroup analysis for the outcome withdrawal symptoms and for adverse events due to lack of pooling.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation abrupt versus continuation of long-term antidepressants
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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
plain- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
- Not matched
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 matchedcites Eveleigh 2018
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
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
“None of these studies distinguished between adverse events and 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) > 3.4 Adverse events
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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
“Evidence for discontinuation of long-term antidepressant use lacks completeness and has low applicability.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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
“For example, low mood and other withdrawal symptoms may register on the Hamilton Rating Scale for Depression (HAM-D) -the prioritised measure for depressive symptoms -and may result in people falsely allocated to having”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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
“Furthermore, physical and emotional symptoms of withdrawal may impair work, socialising, and emotional wellbeing, thereby affecting scores on quality of life and functioning scales.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 did not perform subgroup analysis for the other comparisons (discontinuation with high-intensity psychological intervention or minimal intervention) due to the small number of 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) > See Analysis 5.1 Analysis 6.1 and Analysis 7.1.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 did not perform sensitivity analyses for studies with a co-intervention, for studies with a high-intensity psychological intervention, or for studies with minimal intervention due to the small number of studies.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sensitivity analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“However, we could not perform sensitivity analyses excluding studies at high risk of bias.All included studies had high risk for at least one risk of bias domain.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sensitivity analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 could not perform subgroup analyses based on setting, disorder, type of antidepressant, or duration of antidepressant use prior to randomisation.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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 matchedcites NICE 2009
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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.
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 were unable to analyse subgroups on the basis of age and setting.”
§ 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 5.1 Analysis 6.1 and Analysis 7.1.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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 matchedcites UK Royal College of Psychiatrists 2020
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“This occurs when relapse criteria rely on clinical scale scores that include domains for depressed mood, insomnia, agitation, gastrointestinal somatic symptoms, anxiety, general somatic symptoms, and/or sexual dysfunction -all potential 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) > Overall completeness and applicability of evidence
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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
“however these psychological interventions are resource-intensive, and access is o en limited.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. 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.
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
“Discontinuation may be more appropriate and effective in such a population.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper may give no reason why it holds. 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
“As study endpoints differed, we pooled studies with different follow-up durations.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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
“All things considered, this is a major limitation of our review and may be a source of potential bias; therefore, our findings for relapse should be interpreted with caution.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. 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
“Because pooling was not possible for some outcomes, the potential benefit of a meta-analysis to produce a more precise effect estimate could not be realised; therefore we reduced the evidence by one level for imprecision.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Imprecision
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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
“The effect of this is that abrupt changes in effect on target receptors occur when the dose is reduced to zero, meaning that many of the regimens in the tapering studies are very similar to abrupt cessation, perhaps explaining the lack of success in discontinuation and the apparent 'relapse' rate.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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
“It is important to note that adverse events may include withdrawal symptoms, as the studies did not distinguish between adverse events and 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) > Potential biases in the review process
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 may have missed other relevant studies, especially those with a negative result.”
§ 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
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Definitions of remission and relapse differed widely between studies, and this could introduce bias.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Five studies that are ongoing or awaiting classification have not been included and may be a source of potential bias.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 used a comprehensive search strategy in multiple databases with no restrictions on language.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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 assessed 20 studies to be at unclear risk and one study at high risk for sponsorship bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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
“This is a specific subpopulation of patients taking long-term antidepressants in the community; therefore the generalisability of our results is limited to those with multiple episodes of depression.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Indirectness of evidence
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“A third review author acted as arbiter to minimise risk of bias in the review process.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 conducted a comprehensive search for published and unpublished studies, thereby reducing the risk of publication bias.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Publication bias
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“It is unclear if this difference in study duration impacted the conclusions (however, all except one study had a follow-up period of six months or longer).”
§ 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
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
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
“Therefore, we have provided little detail on whether studies assessed systematically beneficial and harmful effects 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) > Overall completeness and applicability of evidence
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“However, for some outcomes, the effect estimate of the pooled studies had a wide 95% confidence interval, which included the null effect (i.e.no difference between treatments).Therefore, we downgraded the evidence by one level.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Imprecision
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 have not downgraded the evidence for any comparison for inconsistency.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Inconsistency of results
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Two review authors independently selected studies for inclusion, extracted data, and assessed risk of bias.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“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 matchedcites MaGPIe Research Group 2003
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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 could not perform subgroup analyses based on duration for the other comparisons”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
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
“Consequently, the effect of these on outcomes is unknown.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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 matchedcites Lundh 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 matchedcites Fava 1998a
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Long-term psychoactive drug use and psychotherapy, other psychiatric disorders (if not excluded), and baseline antidepressant type or dose were not systematically reported and may be a source of potential bias.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“a slow tapering regimen with very low doses over months or discontinuation with a changed pharmaceutical form (such as liquids or tapering strips) to allow low doses was not included in our review.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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
“Our review did not evaluate different discontinuation support strategies”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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 matchedcites Kaymaz 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 pooled studies with and without co-intervention separately for the primary outcomes successful discontinuation rate and relapse because psychological support may increase the risk on discontinuation and reduce the risk of relapse.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Our review included only four studies of participants with anxiety and therefore is unable to provide a clear conclusion on discontinuation in anxiety disorders.”
§ 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
plainn = 4- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 did not use this criterion to assess performance and detection bias, and this could introduce bias.”
§ 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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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 matchedcites Kaymaz 2008
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Not matched
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
“Withdrawal symptoms are an indication to taper more slowly and do not imply that the underlying disorder has re-emerged.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. 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
“Random sequence generation (selection bias) Low risk Comment: a random component is used”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Incomplete outcome data (attrition bias) All outcomes High risk Comment: 2 participants (10.5%) withdrew before completion of study.Not clear what group they were randomised to.Analysis was done on 17 completing study rather than on 19 randomised”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
plainn = 2- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Selective reporting (reporting bias) High risk Comment: study protocol is available; predefined outcomes were not reported (types of serious adverse events).Other adverse events and withdrawal symptoms were not an outcome”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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
“low participation rate: 15% of participants deemed eligible by the GP; consented to participate”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: study protocol not available; adverse events reported; no withdrawal symptoms measured”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“patient characteristics were well balanced at randomisation; any differences were not statistically significant”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Withdrawal symptoms were measured but were not reported.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: study protocol not available; adverse events reported but incompletely (not all adverse events for each treatment group reported); no information on withdrawal symptoms reported”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: large numbers of dropouts in placebo group and antidepressant group (55/61 (90%) in placebo group and 37/60 (62%) in antidepressant group); only 6/61 placebo patients completed the trial compared to 23/60 citalopram patients”
§ 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
plainn = 61- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Blinding of outcome assessment (detection bias) All outcomes Low risk Comments: study is described as single-blind and it is unlikely that blinding could have been broken”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“ITT analysis on 160/165 patients entered into the RCT with at least 1 post-baseline assessment”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plainn = 165- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Selective reporting (reporting bias) High risk Comment: study protocol not available, although given the age of this study, protocols might not have been standard practice at that time.Study authors report that they assessed participants on the Treatment-Emergent Symptoms Scale, yet adverse events were reported incompletely.Withdrawal symptoms were not an outcome”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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
“Allocation concealment (selection bias) Low risk Comment: an independent research assistant was responsible for allocation (central allocation)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Blinding of outcome assessment (detection bias) All outcomes Low risk Comment: blinding of outcome assessment ensured; likely that blinding was successful”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Other bias Unclear risk Comment: funding not described”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Incomplete outcome data (attrition bias) All outcomes High risk Comment: dropout rates different across groups (28.5% discontinuation group, 35.5% antidepressant group); reasons for dropout not accounted for”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Blinding of outcome assessment (detection bias) All outcomes Low risk Comment: study is described as double-blinded, and blinding appeared to be maintained”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
hedged- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
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.
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
“Comment: no protocol available; withdrawal symptoms not an outcome; incomplete information on adverse events reported”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Blinding of participants and personnel (performance bias) All outcomes Low risk Comment: study is described as double-blinded, and blinding appeared to be maintained”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
hedged- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
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.
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
“random assignment was ensured by picking a sealed envelope with intervention or control group”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Blinding of participants and personnel (performance bias) All outcomes High risk Comments: study is described as single-blind; participants and physicians were not blinded, and the outcome is likely to be influenced by lack of blinding”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“no blinding or incomplete blinding; outcome is likely to be influenced by lack of blinding”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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 matchedcites Mangin 2015
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
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
“Other bias Low risk Comment: none”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Other bias Unclear risk Source of funding not reported”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Blinding of participants and personnel (performance bias) All outcomes High risk Comment: medication withdrawn was not accompanied by the use of placebo.Due to the nature of the trial (monotherapy vs combination therapy), blinding would not be possible for patients and providers”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: no protocol available; relevant outcomes measured; adverse events reported; no 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) > Additional information
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Random sequence generation (selection bias) Unclear risk Comment: not enough information provided.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“random assignment was ensured by picking a sealed envelope with intervention or control group”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“because our trial is cluster randomised, calculations to determine the minimum number of general practices is stricter than in a non-clustered trial.To account for this, we used an ICC of 0.05”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Blinding of outcome assessment (detection bias) All outcomes Low risk Comment: blinding of outcome assessment ensured; unlikely that blinding could have been broken”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“indicating that a time frame of 4 weeks was not considered feasible for many individuals”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. The quote only partly states this claim.
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
“Comment: study report fails to include results for adverse events and withdrawal symptoms that would be expected to have been reported for such a study.None of our secondary outcomes were reported”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Allocation concealment (selection bias) Unclear risk Comment: insufficient information to permit judgement”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: adverse events were reported incompletely (not separated for each treatment group; no numbers for increased sweating); withdrawal symptoms 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) > Additional information
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Allocation concealment (selection bias) Unclear risk Comment: not described”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Comment: protocol is not available; reports include all expected outcomes.Adverse events were reported.Withdrawal symptoms were not an outcome.None of our secondary outcomes were reported”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Blinding of participants and personnel (performance bias) All outcomes Low risk Comment: blinding of participants and key study personnel ensured; unlikely that blinding could have been broken”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Selective reporting (reporting bias) High risk Comment: protocol not available.Hamilton and Raskin scores reported only for total (N = 17) participants and placebo (N = 10) participants.Not reported for active (N = 7) participants.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
plaindirectn = 17- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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
“Random sequence generation (selection bias) Low risk Comment: randomisation was performed by using a computer random number generator”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Random sequence generation (selection bias) Unclear risk Comment: insufficient information to judge”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
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 matchedcites Mangin 2015
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
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
“Allocation concealment (selection bias) Unclear risk Comment: not enough information provided”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“blinding of outcome assessment ensured; unlikely that blinding could have been broken”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Selective reporting (reporting bias) High risk Comment: the study protocol is available, and all of the study's pre-specified (primary and secondary) outcomes have been reported in the pre-specified way.Suspected serious adverse events were recorded and were reported to the ethics committee, although they were not mentioned in the report.Withdrawal symptoms were not an outcome”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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
“Adherence to PCT (i.e.completing ≥ 5 sessions): 90%”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Munkholm 2019
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The quote only partly states this claim.
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
“blinding of outcome assessment ensured; unlikely that blinding could have been broken”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Cochrane Database of Systematic Reviews
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Other bias Unclear risk Comment: grant from pharmaceutical industry”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Incomplete outcome data (attrition bias) All outcomes Low risk Comment: 3/18 withdrew before randomisation but reasons clearly stated”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Intervention 2: continuation of antidepressant treatment
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“The analysis for our primary outcome, discontinuation rate, is reported as ITT.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“However, in the comparison 'discontinuation with other intervention versus usual care', only one cluster-randomised trial provided data (Eveleigh 2018); therefore, we did not adjust the data with the intra-cluster correlation coefficient (ICC).”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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
“Due to the small number of included studies, not all defined subgroup and sensitivity analyses could be performed.”
§ 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
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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 did not carry out an ITT analysis for all outcomes as planned in the protocol.Most studies reported outcomes for all participants, but if data were not available for all participants, we included only participants with a recorded outcome.”
§ 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. 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 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
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
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.
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.”
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.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.9.1 Pooled studies
“The six studies reported severity of illness by measurements of Clinical Global Impressions-Severity (CGI-S), as rated by clinicians (Keller 1998;Keller 2007;Kocsis 2007;Montgomery 2004;Perahia 2009;Rickels 2010).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 2.9.1 Pooled studies
“One study reported PGI-S mean scores for repeated continuous measures over the time of the trial (Rickels 2010).”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Discontinuation in combination with support from low-intensity psychological intervention or psychosocial support
“No studies used low-intensity psychological intervention or psychosocial support to support discontinuation.”
§ 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
“One study compared discontinuation (taper) of antidepressant with low-intensity intervention to usual care (Eveleigh 2018).”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.9.1 Pooled studies
“The six studies were considered suitable for pooling.”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.9.1 Pooled studies
“favouring antidepressant continuation (714 participants, 5 studies; I = 65%; random-effects model).”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.9.1 Pooled studies
“This did not change the direction of the effect but reduced its magnitude (MD 0.44, 95% CI 0.30 to 0.57).”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.9.1 Pooled studies
“Participants in the discontinuation group had higher severity score rated on the CGI-S compared to those in the continuation group (MD 0.31, 95% CI 0.13 to 0.49)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ 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 2.2.
“Khan 2014 compared venlafaxine tapering (n = 139) over one week to venlafaxine continuation (n = 37; control group split to allow comparison of multiple arms) over four weeks.”
§ 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 2.2.
“between the discontinuation group (30/139; 21.6%) and the continuation group (4/36; 11.1%)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ 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
“SF-12 Short Form 36-Item Health Survey SF-36 Short Form 12-item Health Survey”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Secondary outcomes
“measured by Short Form 36 (SF-36; Ware 1992), Short Form 12 (SF-12;Gandek 1998)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Sample size
“Four studies included only participants 65 years of age and older (Cook 1986;Klysner 2002;Streim 2012;Wilson 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
“Studies in people aged 65 years and older are sparse (3 studies), indicating a gap in the evidence.”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Timing of outcome assessment
“We analysed effects of discontinuation over the short term (trials with follow-up of four weeks or less)”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > Study duration
“One study with medium-term follow-up (4 weeks to 24 weeks): four weeks (Khan 2014).”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.2.1 All studies (with and without psychological support)
“Abrupt discontinuation increased the risk of relapse (as defined by study authors) (HR 1.97, 95% confidence interval (CI) 1.56 to 2.50; 1555 participants, 11 studies) compared to discontinuation”
§ Cochrane Database of Systematic Reviews Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults (Review) > 1.2.1 All studies (with and without psychological support)
“A total of 775 (49.8%) participants were included in the pooled discontinuation group, and 780 (50.2%) in the pooled continuation group.”
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.
A note, not an issue: for example, a cited work that was retracted only after this paper was published, which its authors could not have known.
In the paper
“Hollon, 2014, 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, 71, 1157, 10.1001/jamapsychiatry.2014.1054”
Cited work 10.1001/jamapsychiatry.2014.1054 · retraction date not known · this paper published 2021-04-22
Citations
Cites
1 retracted
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
RetractedDiagnostic and Statistical Manual of Mental Disorders
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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.
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An inventory for measuring depression
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The MOS 36-ltem Short-Form Health Survey (SF-36): I. Conceptual Framework and Item Selection
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- 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
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- 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
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- Beck, 1993, Beck Anxiety Inventory Manual
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- Van Weel-Baumgarten, 2012, The NHG guideline depression (second revision of the NHG guideline depressive disorder), Huisarts en Wetenschap, 55, 252
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Cited by
Sorted by citations
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
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…”
BackgroundGastaldon, 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
Metadata
- 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)
- 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
- 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).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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