Predicting response to antidepressant discontinuation in patients with major depressive disorder

About one in ten American adults take antidepressant medications to treat depression. Depression is a serious condition that affects how people feel, think, and act, and antidepressants help manage the symptoms. Each of these patients must decide with their doctor how long to continue to take their medication. This decision should be made with an understanding of the risks and benefits of stopping the medication. One big risk of stopping antidepressant medication too soon is that this can make depression return or worsen. On the other hand, antidepressant medications can have side effects, so people should not continue to take antidepressants without a medical reason. So far, medical science has learned some basic information about when to stop antidepressant medications, but this basic information may not apply to a particular patient who might be different in various ways from the average patient in existing studies. For example, a patient whose depression did not improve much after starting antidepressant may not experience the same response to stopping antidepressant treatment as would a patient whose depression improved a large amount after starting antidepressant, but this has not been carefully studied. We are planning to address this gap by building statistical models that combine patient data from multiple randomized controlled trials in which some patients were randomly assigned to continue their antidepressant treatment for longer, and other patients were randomly assigned to stop their antidepressant early. The overall goal of this study is to inform clinical decision making about when and for which patients antidepressant treatments should be discontinued in patients with major depressive disorder, by predicting how individual patients might respond to antidepressant discontinuation based on their clinical and demographic features, and by combining detailed, person-level data from several randomized trials to provide more precise, patient-specific evidence to guide decisions about when and for whom it may be safe to stop antidepressant treatment.