A qualitative study of patient views on discontinuing long-term selective serotonin reuptake inhibitors.
BACKGROUND
There is concern that patients may be remaining on selective serotonin reuptake inhibitors (SSRIs) longer than is clinically indicated. Previous research has explored patients' experiences of taking SSRIs and decisions about starting medication. There has been less research into patients' reasons for long-term use and their views and experiences of discontinuation.


OBJECTIVE
To explore patient experiences of and beliefs about their long-standing SSRI use and understand the barriers and facilitators to discontinuation.


METHODS
Face-to-face semi-structured qualitative interview study.


METHODS
One group general practice in Southampton, UK.


RESULTS
Three overarching themes were identified: (i) patient uncertainty about the benefits of, and continued need for, SSRI medication; (ii) barriers to stopping, including fear of withdrawal symptoms and fear of relapse; and (iii) the importance of the GP's role in facilitating cessation. Uncertainty and fear about withdrawal symptoms and what patients would be like without their medication were key barriers to stopping, even among patients who felt no discernible benefit from taking SSRIs. Patients indicated a need to share the decision to stop with their GP. However, the majority of patients interviewed had received repeat prescriptions of SSRIs without being reviewed by the GP.


CONCLUSIONS
Patients prescribed SSRI medication need to be reassured that, as with starting medication, thinking about or actually stopping medication is a task that will not be managed in isolation, but with the support of their GP.
Leydon
Geraldine M
GM
Primary Medical Care, Community Clinical Sciences Division, University of Southampton School of Medicine, Aldermoor Health Centre, Aldermoor Close, Southampton SO16 5ST, UK. gerry@soton.ac.uk
Rodgers
Lynne
L
Kendrick
Tony
T
D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003863:Depression / Q000188:drug therapy; D005260:Female; D006123:Group Practice; D006801:Humans; D007407:Interviews as Topic; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D006113:United Kingdom; D028761:Withholding Treatment
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors