What factors influence long-term antidepressant use in primary care? Findings from the Australian diamond cohort study

Long-term antidepressant use: a qualitative study on perspectives of patients and GPs in primary care

“…Previous research suggested that GPs experience time constraints in the care for patients with depressive and/or anxiety disorder(s). 27 Concurrently, long-term users of antidepressants tend to have longer GP visits (with a duration of >20 minutes) 25 and they also experience greater social and physical limitations than non-users and short-term users, 28,29 which may also be a consequence of their remaining disease burden. When it comes to caring for these patients in GP practices, mental health assistants could possibly provide more support to GPs, for example, by monitoring antidepressant use and providing supportive guidance during discontinuation.…”

Did NICE guidelines and the Quality Outcomes Framework change GP antidepressant prescribing in England? Observational study with time trend analyses 2003–2013

“…It has been suggested increasing longterm prescribing is simply the result of correcting what was previously inadequate duration according to guidelines . While longer-term antidepressant use in Australian practices was found to be associated with a history of recurrent depression and more complex mental, physical and social problems, the authors concluded nevertheless that many patients could benefit from treatment re-evaluation (Ambresin et al, 2015). However, reviews of patients taking antidepressants have been found to decline with longer use (Sinclair et al, 2014), reducing the opportunity for review of appropriateness of treatment.…”

Barriers and facilitators to discontinuing antidepressant use: A systematic review and thematic synthesis

“…The main reason for this increase is increasing long-term use, with a median length of treatment now greater than two years (Kendrick et al, 2015;McCrea et al, 2016;Moore et al, 2009). While some people need to use antidepressants long-term to prevent relapse, studies suggest that 30-50% of long-term users have no evidence-based indication to continue and could try stopping (Cruickshank et al, 2008;Ambresin et al, 2015;Piek et al, 2014).…”