title: Impact of duration of antidepressant treatment on the risk of occurrence of a new sequence of antidepressant treatment.
abstract: BACKGROUND
  Despite the recommendation that antidepressant treatment should be continued for several months to reduce the risk of relapse/recurrence of depression, early discontinuation is frequent in naturalistic conditions. The study was aimed at exploring the impact of early discontinuation of antidepressant treatment on the risk of antidepressant re-initiation.
  
  
  METHODS
  A follow-up study of persons (n=35,053) starting antidepressant treatment was performed using a representative sample of the French Social Security Insurance national database.
  
  
  RESULTS
  The risk of re-initiation of antidepressant treatment was higher if the duration of the index episode of antidepressant treatment was ≥ 6 months [hazard ratio (HR)=2.35; 95% CI 2.25-2.45) or 2-5 months (HR=1.65; 95% CI 1.59-1.71) compared to ≤ 1 month. The other characteristics independently associated with re-initiation of treatment were older age, female gender, low income, serious chronic illness, index prescription by a specialist and co-prescription of other psychotropic drugs.
  
  
  CONCLUSIONS
  The lower risk of re-initiation of antidepressant treatment in persons with shorter-than-recommended duration of antidepressant treatment might be explained by overprescription of antidepressants in persons with sub-threshold symptoms.
authors.affiliation: Université Bordeaux 2, Bordeaux, France. helene.verdoux@u-bordeaux2.fr
authors.forename: H
authors.initials: H
authors.lastname: Verdoux
authors.forename: A
authors.initials: A
authors.lastname: Cougnard
authors.forename: A
authors.initials: A
authors.lastname: Thiébaut
authors.forename: M
authors.initials: M
authors.lastname: Tournier
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D016208:Databases, Factual; D003863:Depression / Q000188:drug therapy*; D003866:Depressive Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012008:Recurrence; D012306:Risk; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D011619:Psychotropic Drugs