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30-10-2012 | General practice | Article

Review long-term antidepressants

Abstract

Free abstract

medwireNews: Patients who have been taking antidepressants for 2 years or more should have their medication systematically reviewed, suggests research.

The study conducted at 78 general practices found more than a quarter of long-term antidepressant users needed to have their medication adjusted.

In all, 71 (91%) practices reviewed the medication for 2,849 patients classed as long-term users of antidepressants other than amitriptyline, which was excluded due to its wide use for other conditions.

This resulted in 811 (28.5%) patients having a change to their antidepressant drug treatment, with 12.8% having a reduced dose, 7.0% stopping medication altogether and 3.4% switching antidepressant.

The authors, led by Dr Chris Johnson (NHS Greater Glasgow and Clyde), calculated that this represents a 9.5% reduction in daily prescribed doses and an estimated 8.1%, or £23,320 per year, reduction in prescribing costs.

Writing in the British Journal of General Practice, the authors note that pre-review doses of selective serotonin reuptake inhibitors (SSRIs) were considerably higher than previously reported.

"Current evidence does not support the use of higher SSRI doses for the treatment of depression," they write. "It may be more efficacious to change compliant non- and poor-SSRI responders to a different SSRI rather than increasing the dose."

medwireNews (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price, Senior medwireNews Reporter