Continuing Antidepressants Lowers the Risk of Relapse in Patients Treated for Anxiety Disorders

Dr. Batelaan and colleagues systematically reviewed relapse prevention trials in patients with anxiety disorders who responded to antidepressants. They focused on patients treated for a variety of anxiety disorders, including panic disorder, agoraphobia, social phobia, generalized anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and specific phobias. They included 28 double-blind studies with a maximum follow-up of one year. There were 2625 patients in the antidepressant group and 2608 in the placebo group. All patients responded to antidepressants and were randomly assigned to either continue the antidepressant or switch to placebo. The authors found that relapse rates were higher and time to relapse was shorter when antidepressants were discontinued. The authors conclude that the risk of relapse increases up to one year after discontinuation of antidepressants. In their discussion of the results, they emphasize that the recommendation to continue treatment for a year “should not be interpreted as advice to taper drugs after this period. [..] In addition to relapse, patients’ preferences and adverse effects should be taken into account when deciding whether to continue or discontinue antidepressants.”