Antidepressant deprescribing: State of the art and recommendations—A literature overview.

Introduction: In recent years, the consumption of antidepressants has arisen. However, deprescribing antidepressant therapy is very complicated. The aim of this study was to implement practical recommendations for the development of guidelines to be used for antidepressant deprescription in clinical...

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Publicado en:European Journal of Clinical Pharmacology Vol. 80; no. 3; pp. 417 - 434
Autores principales: Romagnoli, Alessia, Zovi, Andrea, Santoleri, Fiorenzo, Lasala, Ruggero
Formato: research systematic review tables/charts Journal Article
Publicado: Springer Nature Mar2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2024
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      pub: Springer Nature
      place: New York, New York
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        atl: Antidepressant deprescribing: State of the art and recommendations—A literature overview.
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          Romagnoli, Alessia
          Zovi, Andrea
          Santoleri, Fiorenzo
          Lasala, Ruggero
        affil: Territorial Pharmaceutical Service, Local Health Unit Lanciano Vasto Chieti, Chieti, Italy
      sug:
        subj:
          Antidepressive Agents
          Deprescribing Evaluation
          Practice Guidelines
          Program Development
          Medical Practice
          Education, Clinical
          Human
          Systematic Review
          PubMed
          Descriptive Statistics
          Cholinergic Antagonists
          Serotonin Uptake Inhibitors
          Antidepressive Agents, Tricyclic
          Nurses
          Pharmacists
          Multidisciplinary Care Team
      ab: Introduction: In recent years, the consumption of antidepressants has arisen. However, deprescribing antidepressant therapy is very complicated. The aim of this study was to implement practical recommendations for the development of guidelines to be used for antidepressant deprescription in clinical practice. Materials and methods: The literature search has been conducted on March 13, 2023, using Scopus and PubMed databases. The following search string has been used: "antidepressants AND (deprescribing OR deprescription)". All studies reporting a deprescribing intervention for antidepressant medication, regardless of the study design, have been included. Studies that did not report antidepressant drug deprescription interventions and non-English-language papers have been excluded. Results: From the literature search, a total of 230 articles have been extracted. Applying the exclusion criteria, 26 articles have been considered eligible. Most of the analyzed studies (16, 61%) have been carried out in the real world, 3 (11%) were RCTs, 5 (19%) were qualitative studies, in particular expert opinions, 1 (4%) was a literature review, and 1 (4%) was a post-trial observational follow-up of an RCT. In 8 out of 26 studies (31%), the analyzed antidepressants have been specified: 2 (8%) focused on anticholinergics, 2 (8%) on SSRIs, 3 (11%) on tricyclic antidepressants, and 1 (4%) on esketamine. Nineteen out of 26 studies (73%) did not stratify antidepressants by therapeutic class. The sample sizes analyzed in the studies ranged from a minimum of 4 patients to a maximum of 113,909, and 12 studies included geriatric age as an inclusion criterion. A patient's therapy review has been the main deprescribing intervention, and it has been identified in 14 (54%) articles. Interventions have been carried out by clinicians in 4 (15%) studies, general practitioners in 5 (19%) studies, nurses in 2 (8%) studies, pharmacists in 4 (15%) studies, multidisciplinary teams in 10 (38%) studies, and patients in 1 (4%) study. Conclusions: From the literature review, it emerged that there is no clear evidence useful to support clinicians in antidepressant deprescribing interventions.
      pubtype: Academic Journal
      doctype:
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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