Antidepressants should be continued for at least a year after treatment response

Patients with anxiety disorders who respond to antidepressants and then stop treatment face increased risk for relapse in the year after treatment discontinuation, finds a meta-analysis in The BMJ.

The analysis included 28 studies in which 5200 patients with anxiety disorders who responded to antidepressants were randomised to either continue treatment or switch to a placebo, after which they were assessed for relapse. Most of the studies had drug company involvement.

During up to 1 year of follow-up, relapse occurred significantly more often with placebo than with treatment continuation (36% vs. 16% of patients). The authors conclude, "On the basis of the evidence presented here, the advice is to continue antidepressants for at least a year [after treatment response]. After this period, no evidence based advice can be provided."