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Clinical Summary

Adding psychological intervention to antidepressants lowers risk of depressive relapse

Takeaway

  • This meta-analysis found no evidence to suggest that psychological interventions added to tapering antidepressants increase the risk of relapse vs antidepressants alone in patients with multiple previous episodes of depression.
  • Adding a psychological intervention to maintenance antidepressants after remission significantly reduces the risk of relapse compared with antidepressants alone.
Why this matters
  • Healthcare providers and clinical guideline developers can explore how psychological interventions can be routinely recommended and implemented alongside antidepressants to improve patient choice and lower the risk of depressive relapse.

Study design

  • 11 randomised controlled trials (RCTs; n=1559) met eligibility criteria after a search on Embase, PubMed, the Cochrane Library and PsycINFO.
  • Funding: Amsterdam Public Health research institute.
Key results
  • No increased risk of relapse was observed in participants receiving a psychological intervention while tapering antidepressants vs antidepressants alone (6 studies; n=948; risk ratio [RR], 1.02; 95% CI, 0.84-1.25; P=.85; I2, 51%).
  • The risk of relapse was significantly reduced with psychological intervention plus antidepressants vs antidepressants alone (7 studies; n=611; RR, 0.85; 95% CI, 0.74-0.97; P=.01).
Limitations
  • Heterogeneity among included studies.
  • Studies included were only from high-income countries.

References


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