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Appropriate duration of antidepressant medications for prevention of depressive relapse and the impact of life stage

Molecular Psychiatry volume 28, pages 4937–4938 (2023)Cite this article

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TO THE EDITOR:

Estimating the appropriate duration of antidepressant management following remission of depression is clinically useful, and can be accomplished through random assignment of remitters to undergo placebo therapy, 6 months of antidepressant continuation followed by placebo, or continuous antidepressant therapy. The only randomized controlled trial (RCT) of this kind, conducted by Reimherr et al. [1], compared relapse rates among a placebo group, a group that continued antidepressants for 12 weeks before switching to placebo, a group that continued antidepressants for 26 weeks before switching to placebo, and a group that continued antidepressants for 50 weeks. The 12-week group showed a lower relapse rate at 50 weeks than that of the placebo group, while the 26-week group demonstrated a lower relapse rate than that of the 12-week group. No significant differences were noted between relapse rates in the 26-week and 50-week groups. The continuation of antidepressants for at least 26 weeks after remission is recommended, consistent with the results of our meta-analysis of 40 studies and 8890 subjects [2].

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Fig. 1: Relapse rates in major depression with discontinuation or maintenance of antidepressant treatment.

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Authors and Affiliations

  1. Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan

    Masaki Kato

  2. Department of Psychiatry, Faculty of Medicine, Fukuoka University, Fukuoka, Japan

    Hikaru Hori

  3. Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan

    Aran Tajika

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  1. Masaki Kato
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  2. Hikaru Hori
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  3. Aran Tajika
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Contributions

MK had full access to all the data in the study and took responsibility for the integrity of the data and accuracy of the data analysis. MK, HH, and AT performed data acquisition, analysis, and interpretation. MK drafted the manuscript.

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Correspondence to Masaki Kato.

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Competing interests

MK has received grant funding from the Ministry of Health, Labor and Welfare of Japan, the Japan Society for the Promotion of Science, SENSHIN Medical Research Foundation, and Japan Research Foundation for Clinical Pharmacology, and speaker’s honoraria from Sumitomo Dainippon Pharma, Otsuka, Meiji-Seika Pharma, Eli Lilly, MSD K.K., GlaxoSmithKline, Pfizer, Janssen Pharmaceutical, Shionogi, Mitsubishi Tanabe Pharma, Takeda Pharmaceutical, Lundbeck, and Ono Pharmaceutical. AT received lecture fees from Sumitomo Dainippon Pharma, Eisai, Janssen Pharmaceutical, Meiji-Seika Pharma, Mitsubishi Tanabe Pharma, Otsuka and Takeda Pharmaceutical. HH received speaker honoraria from Eisai, Eli Lilly, Janssen Pharmaceutical, Meiji-Seika Pharma, Otsuka, Pfizer, Sumitomo Dainippon Pharma, and Takeda Pharmaceutical.

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Kato, M., Hori, H. & Tajika, A. Appropriate duration of antidepressant medications for prevention of depressive relapse and the impact of life stage. Mol Psychiatry 28, 4937–4938 (2023). https://doi.org/10.1038/s41380-023-02023-0

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