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Published Online: 15 December 2014

Antidepressant Self-Discontinuation: Results From the Collaborative Psychiatric Epidemiology Surveys

Abstract

Objective:

The goal of this study was to examine the extent and correlates of self-discontinuation of antidepressant medications without physician advice.

Methods:

Among 1,411 participants of the nationally representative Collaborative Psychiatric Epidemiology Surveys who reported using antidepressants in the past year, sociodemographic and clinical correlates of self-discontinuation of medication without physician advice or approval were examined, along with participants’ reasons for discontinuation.

Results:

A total of 313 (22%) antidepressant users in the preceding year reported discontinuing their antidepressant medication without physician advice or approval. Older individuals had reduced odds of self-discontinuing antidepressants. Participants with an anxiety or substance use disorder and those prescribed an antidepressant by a provider other than a psychiatrist had higher odds of self-discontinuation. Participants with public insurance had lower odds of self-discontinuation than those with private insurance. The two most commonly reported reasons for self-discontinuation of antidepressants were side effects and experiencing no benefit from the medication.

Conclusions:

Physicians prescribing antidepressants need to clearly communicate the expected benefits of treatment, the minimum duration of use required to experience benefits, and the potential side effects of these medications, particularly to younger patients, those with anxiety disorders, and patients treated in general medical settings, all of whom have increased odds of self-discontinuation.

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Go to Psychiatric Services
Go to Psychiatric Services

Cover: By the Pond, by Mary Cassatt, circa 1898. Color print with dry point and aquatint, fourth and final state (classmark: MEZAP+). Print collection, Miriam and Ira D. Wallach Division of Art, Prints and Photographs, New York Public Library. Photo credit: The New York Public Library/Art Resource, New York City.

Psychiatric Services
Pages: 455 - 462
PubMed: 25930223

History

Received: 17 January 2014
Revision received: 14 July 2014
Accepted: 2 September 2014
Published online: 15 December 2014
Published in print: May 01, 2015

Authors

Details

Hillary Samples, M.H.S.
Ms. Samples is with the Department of Health Policy and Management and Dr. Mojtabai is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (e-mail: [email protected]).
Ramin Mojtabai, M.D., Ph.D.
Ms. Samples is with the Department of Health Policy and Management and Dr. Mojtabai is with the Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (e-mail: [email protected]).

Funding Information

Dr. Mojtabai has received consulting fees from Lundbeck Pharmaceuticals. Ms. Samples reports no financial relationships with commercial interests.

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