Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial.
rct · Level II
Where this comes from
- Record sourced from PubMed, PMID 26892847.
- Also identified by DOI 10.1192/bjp.bp.115.168971 and PMC identifier 4816973.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov:NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n= 249), were randomly allocated to either discontinue (n= 128) or continue (n= 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity. The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity. Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT.
Medical subject headings
- Antidepressive Agents
- Cognitive Behavioral Therapy
- Major Depressive Disorder
- Mindfulness