How do we know that we can stop antidepressants?

In depression, how long do drug treatments last? How does it stop taking antidepressants? How do we know that we are healed? Overview ...

When can anti-depressant therapy be discontinued?

For the physician, the most frequently used healing criteria are the disappearance of symptoms, professional reintegration and resumption of activities. There are, on the other hand, criteria concerning the quality of family reintegration and the opinion of the entourage which also define healing. There is, finally, the subjective experience of the patient. But of course this varies depending on each. Some recover their former state entirely. There is a percentage of patients with residual symptoms: sleep disorders, skepticism, phobias, anxiety .... Finally, 10% of so-called resistant depressions are observed.

Why some treatments last longer?

A well-conducted treatment usually leads to remission of symptoms after two months. It is then necessary to negotiate with the patient the maintenance of the doses and to remain attentive to the evolution The total duration of the treatment is usually of six months (more or less two months). The drug is then stopped by gradually decreasing the doses.

Are there premature stoppages?

The ineffectiveness of treatment may paradoxically explain these longer treatments. This could be misjudged, inadequate, insufficient dosage .... In some cases, the fear of relapse may justify an extension of the prescription beyond the usual recommendations. Moreover, there is often a demand for "better performance" or greater comfort on the part of patients, which increases the healing bar and hence the duration of treatment.
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The analysis of the follow-up of the patients, in the study SOFRES 1997, shows a predominance of treatments "short" with a rate of premature stoppages (less than 4 months) of 61%. One can isolate several reasons for this early termination

However, care must be taken to ensure that treatment is completed. Depressive illness is one of the main risk factors for suicide, if not the most important. Properly treating depression is, for many, preventing suicide. The premature termination of treatment, medicinal and psychotherapeutic therefore carries a risk of suicide. Quality support is therefore paramount.

According to the Itinerary of the depressed report

The feeling of incurability linked to severe depression Perceived improvement in the state of health considered sufficient by the patient Side effects of drugs Fear of becoming addicted to the drug Declining quality of adherence to the recommendations of the patient Physician over time Inadequate medical accompaniment Non-recognition of the need for this therapy by the entourage