Discontinuation of antidepressant treatment: a retrospective cohort study on more than 20,000 participants.

IF 3.6 3区 医学 Q1 PSYCHIATRY
Luis M Garcia-Marin, Aoibhe Mulcahy, Enda M Byrne, Sarah E Medland, Naomi R Wray, Freddy Chafota, Penelope A Lind, Nicholas G Martin, Ian B Hickie, Miguel E Rentería, Adrian I Campos
{"title":"Discontinuation of antidepressant treatment: a retrospective cohort study on more than 20,000 participants.","authors":"Luis M Garcia-Marin, Aoibhe Mulcahy, Enda M Byrne, Sarah E Medland, Naomi R Wray, Freddy Chafota, Penelope A Lind, Nicholas G Martin, Ian B Hickie, Miguel E Rentería, Adrian I Campos","doi":"10.1186/s12991-023-00480-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7942,"journal":{"name":"Annals of General Psychiatry","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10668351/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of General Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12991-023-00480-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0

Abstract

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.

停止抗抑郁药物治疗:一项超过20,000名参与者的回顾性队列研究。
背景:影响抗抑郁药物停药的因素尚不清楚。在目前的研究中,我们的目的是估计抗抑郁药物治疗停止的患病率,并确定与治疗停止相关的人口统计学特征、精神合并症和特定副作用。方法:我们利用了澳大利亚抑郁症遗传学研究(AGDS;N = 20,941)进行一项关于抗抑郁药物停药的回顾性队列研究。如果参与者年满18岁,在过去4年中服用过抗抑郁药,并提供知情同意,则符合条件。结果:在所研究的10种抗抑郁药物中,米氮平(57.3%)和阿米替林(51.6%)的停药率最高。除米氮平外,停药率在两性之间是相当的,女性更有可能停药。性功能减退和体重增加这两种最常见的副作用与停药几率的增加无关。焦虑、躁动、自杀念头、呕吐和皮疹与治疗中断的几率较高有关,终身诊断为PTSD、ADHD和较高的神经质评分也是如此。受教育程度与停药呈负相关(保护性)。结论:我们的研究表明,并不是所有的副作用都会导致停药。常见的副作用如性功能减退和体重增加不一定会增加停药的风险。与停药相关的副作用可分为两组,精神病理相关和过敏/不耐受。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信