Jump to content
Sign in to follow this  

El-Mallakh, 2012 Studies of Long-Term Use of Antidepressants: How Should the Data from Them be Interpreted?

Recommended Posts


Antidepressant withdrawal syndrome contributes to what erroneously appears to be the efficacy of antidepressants in preventing recurrence of depression.

CNS Drugs. 2012 Feb 1;26(2):97-109. doi: 10.2165/11599450-000000000-00000.
Studies of Long-Term Use of Antidepressants: How Should the Data from Them be Interpreted?
El-Mallakh RS, Briscoe B.


Mood Disorders Research Program, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY, USA.

Abstract at http://www.ncbi.nlm.nih.gov/pubmed/22296314 Full text here.

Depression is a recurrent illness in which afflicted individuals have an increased risk for recurrence as a function of a greater number of previous episodes. Consequently, prevention of future episodes is central to improving the prognosis. The current recommendation is to use antidepressants over prolonged periods of time to prevent further episodes of depression. However, the database for this practice is limited and can be interpreted in multiple ways. Review of the relevant literature was performed. MEDLINE and PubMed databases were searched from inception to 5 September 2011 for randomized, placebo-controlled trials of at least 18 months duration. After treatment of an acute depressive episode, antidepressants clearly prevent relapse back into the same depressive episode. This is demonstrated by an adequate number of randomized, blinded, placebo-controlled, 1-year continuation trials. The ability of antidepressants to prevent recurrence of future episodes is less clear. Randomized, blinded, placebo-controlled trials of 18 months or longer are infrequent - 18 studies were identified. While nearly all show that antidepressant continuation is superior to placebo in preventing resurgence of depressive symptoms, nearly all of the difference occurs in the first 6 months after randomization. This pattern strongly suggests that the apparent superiority of antidepressants may be due to (i) their ability to prevent recurrence, (ii) antidepressant withdrawal (characterized by depressive symptoms) in patients switched to placebo or (iii) a combination of these phenomena.

Share this post

Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
Sign in to follow this  


Important Information

By using this site, you agree to our Terms of Use.