Evidence map›Paper›PMID 31349796›Full record

ArticleBMC family practice2019

Discontinuation of antidepressant medication in primary care supported by monitoring plus mindfulness-based cognitive therapy versus monitoring alone: design and protocol of a cluster randomized controlled trial.

Carolien Wentink, Marloes J Huijbers, Peter Lucassen, Cornelis Kramers, Reinier Akkermans, Eddy Adang, Jan Spijker, Anne E M Speckens

Registry-linked trialAbstract read
In one paragraph

Article in BMC family practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03361514 (Discontinuation of Antidepressant Medication in Primary Care Supported by Monitoring Plus Mindfulness-based Cognitive Therapy Versus Monitoring Alone.), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT03361514 nacompletednot on this map

Discontinuation of Antidepressant Medication in Primary Care Supported by Monitoring Plus Mindfulness-based Cognitive Therapy Versus Monitoring Alone.

TypeinterventionalSponsorRadboud University Medical CenterRan2017 to 2019Enrolled119ConditionsAntidepressantsArmsSupported Protocolized Discontinuation (SPD), Mindfulness Based Cognitive Therapy (MBCT)
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Carolien WentinkDepartment of Psychiatry, Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, the Netherlands. carolien.wentink@radboudumc.nl.ORCID 0000-0001-9521-4105
Marloes J HuijbersDepartment of Psychiatry, Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, the Netherlands.
Peter LucassenDepartment of Primary and Community Care, Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, the Netherlands.
Cornelis KramersDepartment of Pharmacology and Toxicology and Department of Internal Medicine, Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, the Netherlands.
Reinier AkkermansDepartment of Primary and Community Care, Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, the Netherlands.
Eddy AdangDepartment for Health Evidence, Radboud University Medical Center Nijmegen, Postbus 9101, 6500 HB, Nijmegen, The Netherlands.
Jan SpijkerPro Persona Nijmegen, GGZ, Reinier Postlaan 6, 6525 GC, Nijmegen, The Netherlands.
Anne E M SpeckensDepartment of Psychiatry, Radboud University Medical Center, Postbus 9101, 6500 HB, Nijmegen, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAntidepressant use continues to rise, mainly explained by an increase in the proportion of patients receiving long term treatment. Although treatment guidelines recommend discontinuation after sustained remission, discontinuing antidepressants appears to be challenging for both patients and general practitioners (GPs). Mindfulness-Based Cognitive Therapy (MBCT) is an effective intervention that reduces the risk of relapse in recurrent depression and might facilitate discontinuation by teaching patients to cope with withdrawal symptoms and fear of relapse. The current study aims to investigate the effectiveness of the combination of Supported Protocolized Discontinuation (SPD) and MBCT in comparison with SPD alone in successful discontinuation of long-term use of antidepressants in primary care.

methodsThis study involves a cluster-randomized controlled trial conducted in primary care patients with long-term use antidepressants with baseline and 6, 9 and 12 months follow-up assessments. Patients choosing to discontinue their medication will be offered a combination of SPD and MBCT or SPD alone. Our primary outcome will be full discontinuation of antidepressant medication (= 0 mg) within 6 months after baseline assessment. Secondary outcome measures will be the severity of withdrawal symptoms, symptoms of depression and anxiety, psychological well-being, quality of life and medical and societal costs. DISCUSSION: In theory, stopping antidepressant medication seems straightforward. In practice however, patients and their GPs appear reluctant to initiate and accomplish this process. Both patients and professionals are in need of appropriate tools and information to better support the process of discontinuing antidepressant medication.

trial registrationClinicalTrials.gov PRS ID: NCT03361514 retrospectively registered October 2017.

Indexed as

Cognitive Behavioral TherapyMindfulnessAntidepressive AgentsDepressionHumansPrimary Health CareQuality of LifeRandomized Controlled Trials as TopicRecurrenceResearch DesignAntidepressive AgentsAntidepressantsDiscontinuationGeneral practitionerLong-term useMindfulness-based cognitive therapyPrimary health careTapering

Identifiers

PMID31349796
PMCPMC6660713

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.