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Discontinuation of antidepressant treatment: a retrospective cohort study on more than 20,000 participants
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Discontinuation of antidepressant treatment: a retrospective cohort study on more than 20,000 participants
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Journal Article
Discontinuation of antidepressant treatment: a retrospective cohort study on more than 20,000 participants
2023
Overview
Background
Factors influencing antidepressant treatment discontinuation are poorly understood. In the present study, we aimed to estimate the prevalence of antidepressant treatment discontinuation and identify demographic characteristics, psychiatric comorbidities, and specific side effects associated with treatment discontinuation.
Methods
We leveraged data from the Australian Genetics of Depression Study (AGDS;
N
= 20,941) to perform a retrospective cohort study on antidepressant treatment discontinuation. Participants were eligible if they were over 18 years of age, had taken antidepressants in the past 4 years, and provided informed consent.
Results
Among the ten antidepressants studied, the highest discontinuation rates were observed for Mirtazapine (57.3%) and Amitriptyline (51.6%). Discontinuation rates were comparable across sexes except for Mirtazapine, for which women were more likely to discontinue. The two most common side effects,
reduced sexual function
and
weight gain,
were not associated with increased odds of treatment discontinuation.
Anxiety
,
agitation
,
suicidal thoughts
,
vomiting,
and
rashes
were associated with higher odds for treatment discontinuation, as were lifetime diagnoses of PTSD, ADHD, and a higher neuroticism score. Educational attainment showed a negative (protective) association with discontinuation across medications.
Conclusions
Our study suggests that not all side effects contribute equally to discontinuation. Common side effects such as
reduced sexual function
and
weight gain
may not necessarily increase the risk of treatment discontinuation. Side effects linked to discontinuation can be divided into two groups, psychopathology related and allergy/intolerance.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
