Does the Length of the First Antidepressant Treatment Episode Influence Risk and Time to a Second Episode?

Helga Gardarsdottir, Erica C. G. van Geffen, Joost J. Stolker, Toine C. G. Egberts, Eibert R. Heerdink*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Antidepressant treatment in primary care is inconsistent with treatment recommendations, and many patients discontinue treatment within 6 months. How this affects treatment outcomes is unknown. The aim of this study was to assess how length of the first antidepressant episode influences risk and time to a second treatment episode within 5 years.The study population included 9423 adults (67% women; mean age, 47.3 years) who initiated selective serotonin reuptake inhibitor use in 1998 or 1999. Based on the length of the first antidepressant treatment episode, patients were divided into early discontinuers (<6 months), continuing users (6-12 months), and persistent users (>12 months). The Cox proportional hazards model was used to estimate risk ratios (RRs) for the association between the length of the first antidepressant treatment episode and time to reinitiating antidepressant treatment.Time to a second treatment episode did not differ significantly between continuing users and early discontinuers (RR, 0.99; 95% confidence interval, 0.92-1.07). Persistent users showed a higher risk of experiencing a second treatment episode than early discontinuers (RR, 1.23; 95% confidence interval, 1.15-1.32).In conclusion, the risk of experiencing a second antidepressant treatment episode did not differ for those who used antidepressants for 6 to 12 months and those who discontinued early. In general, there is limited information on how length of an antidepressant treatment episode influences the risk of reinitiating treatment of patients in primary care. More research is needed to investigate the effectiveness of antidepressant drug treatment patterns in preventing relapse or recurrence in primary care populations.

Original languageEnglish
Pages (from-to)69-72
Number of pages4
JournalJournal of Clinical Psychopharmacology
Volume29
Issue number1
DOIs
Publication statusPublished - Feb 2009

Keywords

  • Antidepressive Agents
  • Depressive Disorder
  • Drug Administration Schedule
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Netherlands
  • Patient Compliance
  • Patient Dropouts
  • Secondary Prevention
  • Serotonin Uptake Inhibitors
  • Treatment Refusal

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