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Predicting relapse after antidepressant withdrawal – a systematic review

A substantial proportion of the burden of depression arises from its recurrent nature. The risk of relapse after antidepressant medication (ADM) discontinuation is high but not uniform. Predictors of individual relapse risk after antidepressant discontinuation could help to guide treatment and mitig...

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Autores principales: Berwian, I. M., Walter, H., Seifritz, E., Huys, Q. J. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5244448/
https://www.ncbi.nlm.nih.gov/pubmed/27786144
http://dx.doi.org/10.1017/S0033291716002580
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author Berwian, I. M.
Walter, H.
Seifritz, E.
Huys, Q. J. M.
author_facet Berwian, I. M.
Walter, H.
Seifritz, E.
Huys, Q. J. M.
author_sort Berwian, I. M.
collection PubMed
description A substantial proportion of the burden of depression arises from its recurrent nature. The risk of relapse after antidepressant medication (ADM) discontinuation is high but not uniform. Predictors of individual relapse risk after antidepressant discontinuation could help to guide treatment and mitigate the long-term course of depression. We conducted a systematic literature search in PubMed to identify relapse predictors using the search terms ‘(depress* OR MDD*) AND (relapse* OR recurren*) AND (predict* OR risk) AND (discontinu* OR withdraw* OR maintenance OR maintain or continu*) AND (antidepress* OR medication OR drug)’ for published studies until November 2014. Studies investigating predictors of relapse in patients aged between 18 and 65 years with a main diagnosis of major depressive disorder (MDD), who remitted from a depressive episode while treated with ADM and were followed up for at least 6 months to assess relapse after part of the sample discontinued their ADM, were included in the review. Although relevant information is present in many studies, only 13 studies based on nine separate samples investigated predictors for relapse after ADM discontinuation. There are multiple promising predictors, including markers of true treatment response and the number of prior episodes. However, the existing evidence is weak and there are no established, validated markers of individual relapse risk after antidepressant cessation. There is little evidence to guide discontinuation decisions in an individualized manner beyond overall recurrence risk. Thus, there is a pressing need to investigate neurobiological markers of individual relapse risk, focusing on treatment discontinuation.
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spelling pubmed-52444482017-02-01 Predicting relapse after antidepressant withdrawal – a systematic review Berwian, I. M. Walter, H. Seifritz, E. Huys, Q. J. M. Psychol Med Review Article A substantial proportion of the burden of depression arises from its recurrent nature. The risk of relapse after antidepressant medication (ADM) discontinuation is high but not uniform. Predictors of individual relapse risk after antidepressant discontinuation could help to guide treatment and mitigate the long-term course of depression. We conducted a systematic literature search in PubMed to identify relapse predictors using the search terms ‘(depress* OR MDD*) AND (relapse* OR recurren*) AND (predict* OR risk) AND (discontinu* OR withdraw* OR maintenance OR maintain or continu*) AND (antidepress* OR medication OR drug)’ for published studies until November 2014. Studies investigating predictors of relapse in patients aged between 18 and 65 years with a main diagnosis of major depressive disorder (MDD), who remitted from a depressive episode while treated with ADM and were followed up for at least 6 months to assess relapse after part of the sample discontinued their ADM, were included in the review. Although relevant information is present in many studies, only 13 studies based on nine separate samples investigated predictors for relapse after ADM discontinuation. There are multiple promising predictors, including markers of true treatment response and the number of prior episodes. However, the existing evidence is weak and there are no established, validated markers of individual relapse risk after antidepressant cessation. There is little evidence to guide discontinuation decisions in an individualized manner beyond overall recurrence risk. Thus, there is a pressing need to investigate neurobiological markers of individual relapse risk, focusing on treatment discontinuation. Cambridge University Press 2017-02 2016-10-27 /pmc/articles/PMC5244448/ /pubmed/27786144 http://dx.doi.org/10.1017/S0033291716002580 Text en © Cambridge University Press 2016 http://creativecommons.org/licenses/by/4.0/ This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Berwian, I. M.
Walter, H.
Seifritz, E.
Huys, Q. J. M.
Predicting relapse after antidepressant withdrawal – a systematic review
title Predicting relapse after antidepressant withdrawal – a systematic review
title_full Predicting relapse after antidepressant withdrawal – a systematic review
title_fullStr Predicting relapse after antidepressant withdrawal – a systematic review
title_full_unstemmed Predicting relapse after antidepressant withdrawal – a systematic review
title_short Predicting relapse after antidepressant withdrawal – a systematic review
title_sort predicting relapse after antidepressant withdrawal – a systematic review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5244448/
https://www.ncbi.nlm.nih.gov/pubmed/27786144
http://dx.doi.org/10.1017/S0033291716002580
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