Vragen en problemen bij stoppen met antidepressiva

Objective: To assess whether concerns and problems experienced with drug discontinuation occur more frequently in patients using antidepressants than in patients using benzodiazepines, antipsychotics or non-psychiatric medication. Clinical trials and epidemiological studies have shown that premature discontinuation is a major problem during antidepressant therapy. There is little information on how patients perceive treatment with antidepressants in clinical practice, and it is unclear whether patients perceive discontinuation as a problem. Design and methods: All calls to a Dutch national telephone medicines infotmation service received between 1990 and 2004 were examined retrospectively. Calls about discontinuation were identified and classified either as a genetal question about discontinuation, or as a problem experienced with discontinuation. These calls were grouped into four main classes: antidepressants, antipsychotics, benzodiazepines or non-psychiatric medicines. Results: Of all 39,786 registered phone calls, 6,159 (15-5%) related to antidepressants, 1,658 (4.2%) to antipsychotics and 3,916 (9.8%) to benzodiazepines. Patients calling about antidepressants called about discontinuation three times as often [odds ratio (OR) 2.8; 95% confidence interval (CI95) 2.6-3.0], and reported a problem with discontinuation five times more often (OR 5.4; CI95 4,6-6.3) than patients who called about non-psychiatric medicines. The proportion of questions about discontinuation and problems experienced with discontinuation was also higher in patients calling about benzodiazepines and antipsychotics than in patients calling about non-psychiatric medication. Conclusion: Patients perceive discontinuation of antidepressants, as well as discontinuation of antipsychotics and benzodiazepines, as a problem. Discontinuation seems a general problem for all psychiatric medicines, and needs more attention in the communication between patients and healthcare providers.