Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-20106
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dc.contributor.authorHengartner, Michael Pascal-
dc.date.accessioned2020-06-04T10:16:58Z-
dc.date.available2020-06-04T10:16:58Z-
dc.date.issued2020-
dc.identifier.issn2045-1253de_CH
dc.identifier.issn2045-1261de_CH
dc.identifier.urihttps://digitalcollection.zhaw.ch/handle/11475/20106-
dc.description.abstractThe aim of this article is to discuss the validity of relapse prevention trials and the issue of withdrawal confounding in these trials. Recommendations for long-term antidepressant treatment are based almost exclusively on discontinuation trials. In these relapse prevention trials, participants with remitted depression are randomised either to have the antidepressant abruptly discontinued and replaced by inert placebo or to continue active treatment. The drug-placebo difference in relapse rates at the end of the maintenance phase is then interpreted as a prophylactic drug effect. These trials consistently produce remarkable benefits for maintenance treatment. However, the internal validity of this trial protocol is compromised, as research has shown that abruptly stopping antidepressants can cause severe withdrawal reactions that lead to (or manifest as) depression relapses. That is, there is substantial withdrawal confounding in discontinuation trials, which renders their findings uninterpretable. It is not clear to what degree the drug-placebo separation in relapse prevention (discontinuation) trials is due to withdrawal reactions, but various estimations suggest that it is presumably the majority. A review of findings based on other methodologies, including real-world long-term effectiveness trials like STAR*D and various naturalistic cohort studies, do not indicate that antidepressants have considerable prophylactic effects. As absence of evidence does not imply evidence of absence, no definitive conclusions can be drawn from the literature. To enable a thorough risk-benefit evaluation, real-world effectiveness trials should not only focus on relapse prevention, but also assess antidepressants' long-term effects on social functioning and quality of life. Thus far, reliable long-term data on these outcome domains are lacking.de_CH
dc.language.isoende_CH
dc.publisherSagede_CH
dc.relation.ispartofTherapeutic Advances in Psychopharmacologyde_CH
dc.rightshttp://creativecommons.org/licenses/by-nc/4.0/de_CH
dc.subjectantidepressantde_CH
dc.subjectdiscontinuationde_CH
dc.subjectlong-termde_CH
dc.subjectpreventionde_CH
dc.subjectrelapsede_CH
dc.subjectwithdrawalde_CH
dc.subject.ddc615: Pharmakologie und Therapeutikde_CH
dc.titleHow effective are antidepressants for depression over the long term? A critical review of relapse prevention trials and the issue of withdrawal confoundingde_CH
dc.typeBeitrag in wissenschaftlicher Zeitschriftde_CH
dcterms.typeTextde_CH
zhaw.departementAngewandte Psychologiede_CH
zhaw.organisationalunitPsychologisches Institut (PI)de_CH
dc.identifier.doi10.1177/2045125320921694de_CH
dc.identifier.doi10.21256/zhaw-20106-
dc.identifier.pmid32435449de_CH
zhaw.funding.euNode_CH
zhaw.originated.zhawYesde_CH
zhaw.publication.statuspublishedVersionde_CH
zhaw.volume10de_CH
zhaw.publication.reviewPeer review (Publikation)de_CH
zhaw.webfeedKlinische Psychologiede_CH
zhaw.author.additionalNode_CH
zhaw.display.portraitYesde_CH
Appears in collections:Publikationen Angewandte Psychologie

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Hengartner, M. P. (2020). How effective are antidepressants for depression over the long term? A critical review of relapse prevention trials and the issue of withdrawal confounding. Therapeutic Advances in Psychopharmacology, 10. https://doi.org/10.1177/2045125320921694
Hengartner, M.P. (2020) ‘How effective are antidepressants for depression over the long term? A critical review of relapse prevention trials and the issue of withdrawal confounding’, Therapeutic Advances in Psychopharmacology, 10. Available at: https://doi.org/10.1177/2045125320921694.
M. P. Hengartner, “How effective are antidepressants for depression over the long term? A critical review of relapse prevention trials and the issue of withdrawal confounding,” Therapeutic Advances in Psychopharmacology, vol. 10, 2020, doi: 10.1177/2045125320921694.
HENGARTNER, Michael Pascal, 2020. How effective are antidepressants for depression over the long term? A critical review of relapse prevention trials and the issue of withdrawal confounding. Therapeutic Advances in Psychopharmacology. 2020. Bd. 10. DOI 10.1177/2045125320921694
Hengartner, Michael Pascal. 2020. “How Effective Are Antidepressants for Depression over the Long Term? A Critical Review of Relapse Prevention Trials and the Issue of Withdrawal Confounding.” Therapeutic Advances in Psychopharmacology 10. https://doi.org/10.1177/2045125320921694.
Hengartner, Michael Pascal. “How Effective Are Antidepressants for Depression over the Long Term? A Critical Review of Relapse Prevention Trials and the Issue of Withdrawal Confounding.” Therapeutic Advances in Psychopharmacology, vol. 10, 2020, https://doi.org/10.1177/2045125320921694.


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