Discontinuation of antidepressants heightens relapse risk rate compared to continuation of treatment
January 2nd, 2018
Filed under: Anxiety disorder by ATAC Team

Anxiety disorders are one of the major mental health issues that have led to numerous socioeconomic problems. A considerable proportion of the burden surfaces due to the increased risk of relapses among patients post recovery. As highlighted by the American Psychiatric Association (APA), more than half of the people with the first episode of depression will likely have a second episode in near future and the majority of them will have further episodes.

The entire goal of preventing relapses after a phase of antidepressants has become a crucial component of treatment. This is because the chronic course trajectories and relapses after remission have become quite common in the case of anxiety disorders. While cognitive behavioral therapy (CBT) is essential in the treatment process, antidepressants are always the first line option for addressing anxiety disorders because of their efficacy. This stands valid particularly in the case of the acute episodes of depression

Many people are aware of these antidepressants. These medications work by altering the levels of neurotransmitters that are appended to the receptors on neurons throughout the body and affect their activities. However, these neurons eventually adjust to the ebb of the chemical messengers and in addition, may manifest as symptoms ranging from mild to upsetting ones.

Consequently, due to abrupt quitting of the medications, a person may undergo uneasiness or a distressing phase. Therefore, it is essential to continue these medications for up to 12 months after recovery to reduce the risk of a relapse. Thereafter, the treatment with antidepressants calls for weighing of the pros and cons.

Relapse due to cut-down of antidepressant intake

According to a meta-analysis published in the British Medical Journal (BMJ), patients who were struggling with an anxiety disorder and had responded to antidepressants had lower relapse rates. They even took a longer time to relapse on the continuation of the depression treatment at up to one year of follow-up.

In order to determine whether the risk of relapse or time to relapse in this population was related to a specific type of anxiety disorder, duration of previous treatment  and follow-up, mode of discontinuation, or concurrence or absence of psychotherapy, the authors of this study carried out a systematic analysis of relapse prevention trials from different studies.

The authors then selected trials that focused on the patients with a variety of anxiety disorders, including panic disorder, agoraphobia, social phobia, GAD, obsessive-compulsive disorder (OCD), post-traumatic stress disorder and specific phobias, including patients with comorbidities. Overall, there were about 2,625 patients in the antidepressant group and 2,608 in the placebo group. Participants who were selected for the study had responded to antidepressants and were arbitrarily assigned to either continue taking antidepressants or move to a placebo.

While comparing the relapse rates and the time required, it was found that at up to one year of follow-up, the subjects who stopped taking the antidepressant treatment, portrayed higher rates of relapse compared to those who continued taking their medications. However, the relapse rates were 36.4 percent in the placebo group and 16.4 percent in the antidepressant group.

Furthermore, researchers concluded that relapse rate and time required to relapse were not significantly affected by the type of anxiety disorder, duration of the previous treatment, duration of the follow-up, mode of discontinuation, or concurrence or absence of psychotherapy.

Road to recovery

Anxiety disorders affect nearly 40 million people aged 18 and above in the U.S. Despite being one of the highly treatable disorders, many people fail to access an effective treatment. A range of symptoms may crop up if one discontinues the use of antidepressants. The symptoms of withdrawal may often include physical issues that are not commonly found in depression, such as dizziness, flu-like symptoms and abnormal sensations.

If you or someone you love is struggling with any kind of anxiety disorder, contact the Anxiety Treatment Advisors of Colorado to access a variety of evidence-based treatment plans. Call our 24/7 helpline number 866-891-2539 or chat online to connect with the best anxiety disorders treatment centers in Colorado.

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