Does the Length of the First Antidepressant Treatment Episode Influence Risk and Time to a Second Episode?
Abstract
Antidepressant treatment in primary care is inconsistent with treatment recommendations, and many patients discontinue treatment within 6 months. How this affects treatment outcomes is unknown. The aim of this study was to assess how length of the first antidepressant episode influences risk and time to a second treatment episode within 5 years.The study population included 9423 adults (67% women; mean age, 47.3 years) who initiated selective serotonin reuptake inhibitor use in 1998 or 1999. Based on the length of the first antidepressant treatment episode, patients were divided into early discontinuers (<6 months), continuing users (6-12 months), and persistent users (>12 months). The Cox proportional hazards model was used to estimate risk ratios (RRs) for the association between the length of the first antidepressant treatment episode and time to reinitiating antidepressant treatment.Time to a second treatment episode did not differ significantly between continuing users and early discontinuers (RR, 0.99; 95% confidence interval, 0.92-1.07). Persistent users showed a higher risk of experiencing a second treatment episode than early discontinuers (RR, 1.23; 95% confidence interval, 1.15-1.32).In conclusion, the risk of experiencing a second antidepressant treatment episode did not differ for those who used antidepressants for 6 to 12 months and those who discontinued early. In general, there is limited information on how length of an antidepressant treatment episode influences the risk of reinitiating treatment of patients in primary care. More research is needed to investigate the effectiveness of antidepressant drug treatment patterns in preventing relapse or recurrence in primary care populations.
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In naturalistic studies of patients treated with SSRIs, longer duration of antidepressant treatment was associated with greater likelihood of recurrence.
“In naturalistic studies of patients treated SSRI,70,71 the longer the duration of antidepressant treatment, the more likely were the patients to recur.”
From May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance (2020) · cites this paper as [70]
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- Authors
- Gardarsdottir, H., van Geffen, E. C. G., Stolker, J. J., Egberts, T. C. G., & Heerdink, E. R.
- Affiliations
- Utrecht University (NL)
- Corresponding author
- Stolker, Joost J.
- Egberts, Toine C.G.
- Heerdink, Eibert R.
- Venue
- Journal of Clinical Psychopharmacology
- Published
- 2009-02
- Volume
- 29
- Issue
- 1
- Pages
- 69-72
- ISSN
- 0271-0749 (ISSN-L)
- OpenAlex
- W2079846272
- Cited by
- 27
- References
- 29
- Citations by year
- 2026: 1 · 2024: 2 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 3 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 2 · 2014: 1 · 2012: 2
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Clinical Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Keywords
- antidepressant treatment duration, selective serotonin reuptake inhibitors, antidepressant discontinuation, relapse, recurrence, primary care, depression, treatment patterns
- MeSH terms
- Antidepressive Agents, Depressive Disorder, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Male, Middle Aged, Netherlands, Patient Compliance, Patient Dropouts, Treatment Refusal, Selective Serotonin Reuptake Inhibitors, Secondary Prevention
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