Articlehybrid2016

Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: Randomised controlled non-inferiority trial

Marloes J. Huijbers · Philip Spinhoven · Jan Spijker · Henricus Gerardus Ruhé · Anneke van Schaik · Patricia van Oppen +8 more

58 citations0/0 files storedThe British Journal of Psychiatry

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Mindfulness and Compassion Interventions Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Treatment of Major Depression

Abstract

BACKGROUND: 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. AIMS: To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. METHOD: 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. RESULTS: 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. CONCLUSIONS: Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT.

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References

1977The Measurement of Observer Agreement for Categorical Data 2012Cognitive Therapy for Depression 1998Development of the World Health Organization WHOQOL-BREF Quality of Life Assessment 2008Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness 2000Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy.1996The Inventory of Depressive Symptomatology (IDS): psychometric properties 1980Cognitive Therapy of Depression 2006Mindfulness-based cognitive therapy for depression

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