Observational studyThe British journal of general practice : the journal of the Royal College of General Practitioners2012
Reviewing long-term antidepressants can reduce drug burden: a prospective observational cohort study.
Observational study in The British journal of general practice : the journal of the Royal College of General Practitioners, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06091163 (A Randomised Controlled Trial Evaluating the Efficacy and Mechanisms of a Ketogenic Diet as an Adjunctive Treatment for People With Treatment-resistant Depression), which is not on this map. Cited by 46 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomised Controlled Trial Evaluating the Efficacy and Mechanisms of a Ketogenic Diet as an Adjunctive Treatment for People With Treatment-resistant Depression
Who cites it
46 citing papers in PubMed, 10 syntheses or guidelines pooled it, 110 citations in OpenAlex.
- Incidence and risk factors of antidepressant withdrawal symptoms: a meta-analysis and systematic review.Molecular psychiatry · 2025Pooled it
- Pooled it
- The risks of adverse events with mirtazapine for adults with major depressive disorder: a systematic review with meta-analysis and trial sequential analysis.BMC psychiatry · 2025Pooled it
- The risks of adverse events with venlafaxine for adults with major depressive disorder: a systematic review of randomised clinical trials with meta-analysis and Trial Sequential Analysis.Epidemiology and psychiatric sciences · 2024Pooled it
- Beneficial and harmful effects of tricyclic antidepressants for adults with major depressive disorder: a systematic review with meta-analysis and trial sequential analysis.BMJ mental health · 2024Pooled it
- Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.The Cochrane database of systematic reviews · 2021Pooled it
- Pooled it
- Managing Antidepressant Discontinuation: A Systematic Review.Annals of family medicine · 2019Pooled it
- Association of Focused Medication Review With Optimization of Psychotropic Drug Prescribing: A Systematic Review and Meta-analysis.JAMA network open · 2018Pooled it
- Risk of relapse after antidepressant discontinuation in anxiety disorders, obsessive-compulsive disorder, and post-traumatic stress disorder: systematic review and meta-analysis of relapse prevention trials.BMJ (Clinical research ed.) · 2017Pooled it
- Trial
- Implementing physician-led medication reviews for patients with diabetes and severe mental disorder: A randomized controlled trial.British journal of clinical pharmacology · 2025Trial
- Internet and Telephone Support for Discontinuing Long-Term Antidepressants: The REDUCE Cluster Randomized Trial.JAMA network open · 2024Trial
- Trial
- Management of treatment-resistant depression in primary care: a mixed-methods study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Trial
- Structured Online Support to Inform and Assist Antidepressant Deprescribing in Primary Care (WiserAD Tool): Protocol for a Pragmatic Randomized Controlled Trial.JMIR research protocols · 2026Article
- Applying the Behavioural Science Approach to Realist Reviews and Evaluations (BARR/E): A Protocol for a Review of Antidepressant Deprescribing Interventions in Primary Care.Behavioral sciences (Basel, Switzerland) · 2026Article
- A survey of community pharmacists perspectives on monitoring antidepressant adverse events.British journal of clinical pharmacology · 2026Article
- Patients' Perspectives on Antidepressant Discontinuation and the Pharmacists' Role.Basic & clinical pharmacology & toxicology · 2026Article
- Antidepressant prescribing in Australian primary care: time to reevaluate.The Medical journal of Australia · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAntidepressant prescribing continues to rise. Contributing factors are increased long-term prescribing and possibly the use of higher selective serotonin re-uptake inhibitor (SSRI) doses.
aimTo review general practice patients prescribed the same antidepressant long-term (≥2 years) and evaluate prescribing and management pre and post-review. DESIGN AND
settingProspective observational cohort study using routine data from 78 urban general practices, Scotland.
methodAll patients prescribed antidepressants (excluding amitriptyline) for ≥2 years were identified from records November 2009 to March 2010. GPs selected patients for face-to-face review of clinical condition and medication, December 2009 to September 2010. Pre- and post-review data were collected; average antidepressant doses and changes in prescribed daily doses were calculated. Onward referral to support services was recorded.
results8.6% (33 312/388 656) of all registered patients were prescribed an antidepressant, 47.1% (15 689) were defined as long-term users and 2849 (18.2%) were reviewed. 811 (28.5%) patients reviewed had a change in antidepressant therapy: 7.0% stopped, 12.8% reduced dose, 5.3% increased dose, and 3.4% changed antidepressant, resulting in 9.5% (95% CI = 9.1% to 9.8% P<0.001) reduction in prescribed daily dose and 8.1% reduction in prescribing costs. 6.3% were referred onwards, half to NHS Mental Health Services. Pre-review SSRI doses were 10-30% higher than previously reported.
conclusionAlmost half of all people prescribed antidepressants were long-term users. Appropriate reductions in prescribing can be achieved by reviewing patients. Higher SSRI doses may be contributing to current antidepressant growth.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.