Deprescribing antidepressants for depression - what is the evidence for and against?

IF 1.2 4区 医学 Q4 PSYCHIATRY Australasian Psychiatry Pub Date : 2024-09-06 DOI:10.1177/10398562241282377
Jeffrey Cl Looi, Stephen Allison, Tarun Bastiampillai, Steve Kisely, Paul A Maguire, Luke S-C Woon, Katrina Anderson, Gin S Malhi
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Abstract

Objective: Recent guidelines suggest that the overall quantity and duration of antidepressant prescriptions should be reduced. In this paper, we comment on the evidence both for and against this view.

Methods: We critically review the arguments proposed by proponents of antidepressant deprescribing in the context of the evidence-base for the treatment of depression.

Results: Proponents of deprescribing do not address the substantive issues of whether inappropriate prescribing has been demonstrated, and when prescribing is needed. Their arguments for deprescribing are rebutted in this context.

Conclusions: Whether or not to deprescribe antidepressant medication needs to take into consideration the risk-benefit profile of the decision, the responsibility for which needs to be shared and based on the context of the patient's depression, their preferences, experiences and perspectives.

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取消抗抑郁药治疗抑郁症--支持和反对的证据是什么?
目的:最近的指导方针建议减少抗抑郁药物处方的总量和持续时间。在本文中,我们对支持和反对这一观点的证据进行了评论:方法:我们根据抑郁症治疗的证据基础,批判性地回顾了支持减少抗抑郁药处方者提出的论点:结果:取消处方的支持者并未解决是否已证明处方不当以及何时需要处方等实质性问题。在这种情况下,他们主张取消处方的论点遭到了反驳:是否取消抗抑郁药物处方需要考虑到这一决定的风险-收益情况,需要根据患者的抑郁情况、偏好、经历和观点来共同承担责任。
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来源期刊
Australasian Psychiatry
Australasian Psychiatry 医学-精神病学
CiteScore
2.80
自引率
5.60%
发文量
159
审稿时长
6-12 weeks
期刊介绍: Australasian Psychiatry is the bi-monthly journal of The Royal Australian and New Zealand College of Psychiatrists (RANZCP) that aims to promote the art of psychiatry and its maintenance of excellence in practice. The journal is peer-reviewed and accepts submissions, presented as original research; reviews; descriptions of innovative services; comments on policy, history, politics, economics, training, ethics and the Arts as they relate to mental health and mental health services; statements of opinion and letters. Book reviews are commissioned by the editor. A section of the journal provides information on RANZCP business and related matters.
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