Discontinuing antidepressants requires careful planning
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The decision to stop prescribing long-term anti-depressants should be made only after careful preparation by GPs and their patients, University of Queensland research has found.

Most antidepressant prescriptions are generated in general practice, and it is likely that attempts to discontinue are either not occurring or are proving unsuccessful. The study was aimed to explore GPs’ insights about long-term antidepressant prescribing and discontinuation.

Semi-structured interviews explored GPs’ discontinuation experiences, decision-making, perceived risks and benefits, and support for patients. Data were analyzed using reflexive thematic analysis.

Three overarching themes were identified from interviews with 22 GPs.

-- The first, ‘not a simple deprescribing decision’, spoke to the complex decision-making GPs undertake in determining whether a patient is ready to discontinue.

--The second, ‘a journey taken together’, captured a set of steps GPs take together with their patients to initiate and set-up adequate support before, during, and after discontinuation.

--The third, ‘supporting change in GPs’ prescribing practices’, described what GPs would like to see change to better support them and their patients to discontinue antidepressants.

GPs see discontinuation of long-term antidepressant use as more than a simple deprescribing decision. It begins with considering a patient’s social and relational context, and is a journey involving careful preparation, tailored care, and regular review.

Source: https://bjgp.org/content/early/2021/04/19/BJGP.2020.0913