ArticleThe British journal of psychiatry : the journal of mental science2023
Association between polypharmacy and depression relapse in individuals with comorbid depression and type 2 diabetes: a UK electronic health record study.
Article in The British journal of psychiatry : the journal of mental science, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Wise Prescriptions: Prevalence and Predictors of Polypharmacy in Patients with Type 2 Diabetes Mellitus in Primary Care: A Retrospective Cross-Sectional Study.Journal of clinical medicine · 2026Article
- Medication adherence in hypertension and diabetes comorbidity: implications for disease control in a population-based study.Frontiers in public health · 2026Article
- Development of a Japanese version of the patient perceptions of deprescribing - Short form.Journal of general and family medicine · 2025Article
- Mental Health Polypharmacy in "Non-Coded" Primary Care Patients: The Effect of Deprescribing.Journal of clinical medicine · 2024Article
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Authors and funding
6 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundIndividuals with physical comorbidities and polypharmacy may be at higher risk of depression relapse, however, they are not included in the 'high risk of relapse' group for whom longer antidepressant treatment durations are recommended.
aimsIn individuals with comorbid depression and type 2 diabetes (T2DM), we aimed to investigate the association and interaction between depression relapse and (a) polypharmacy, (b) previous duration of antidepressant treatment.
methodThis was a cohort study using primary care data from the UK Clinical Practice Research Datalink (CPRD) from years 2000 to 2018. We used Cox regression models with penalised B-splines to describe the association between restarting antidepressants and our two exposures.
resultsWe identified 48 001 individuals with comorbid depression and T2DM, who started and discontinued antidepressant treatment during follow-up. Within 1 year of antidepressant discontinuation, 35% of participants restarted treatment indicating depression relapse. As polypharmacy increased, the rate of restarting antidepressants increased until a maximum of 18 concurrent medications, where individuals were more than twice as likely to restart antidepressants (hazard ratio (HR) = 2.15, 95% CI 1.32-3.51). As the duration of previous antidepressant treatment increased, the rate of restarting antidepressants increased - individuals with a previous duration of ≥25 months were more than twice as likely to restart antidepressants than those who previously discontinued in <7 months (HR = 2.36, 95% CI 2.25-2.48). We found no interaction between polypharmacy and previous antidepressant duration.
conclusionsPolypharmacy and longer durations of previous antidepressant treatment may be associated with depression relapse following the discontinuation of antidepressant treatment.
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