Impact of Duration of Antidepressant Treatment on the Risk of Occurrence of a New Sequence of Antidepressant Treatment

Abstract

Introduction: Despite the recommendation that antidepressant treatment should be continued for several months to reduce the risk of relapse/recurrence of depression, early discontinuation is frequent in naturalistic conditions. The study was aimed at exploring the impact of early discontinuation of antidepressant treatment on the risk of antidepressant re-initiation.

Methods: A follow-up study of persons (n=35 053) starting antidepressant treatment was performed using a representative sample of the French Social Security Insurance national database.

Results: The risk of re-initiation of antidepressant treatment was higher if the duration of the index episode of antidepressant treatment was ≥6 months [hazard ratio (HR)=2.35; 95% CI 2.25–2.45) or 2–5 months (HR=1.65; 95% CI 1.59–1.71) compared to ≤1 month. The other characteristics independently associated with re-initiation of treatment were older age, female gender, low income, serious chronic illness, index prescription by a specialist and co-prescription of other psychotropic drugs.

Conclusions: The lower risk of re-initiation of antidepressant treatment in persons with shorter-than-recommended duration of antidepressant treatment might be explained by overprescription of antidepressants in persons with sub-threshold symptoms.

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