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 G. Ruhé, Digna J F Van Schaik, Patricia Van Oppen, Willem A Nolen, Johan Ormel, Willem Kuyken, Gert Jan Van der Wilt, Marc B J Blom, Aart H Schene, A Rogier, T Donders, Anne E. M. Speckens
The British Journal of Psychiatry April 2016 DOI: 10.1192/bjp.bp.115.168971 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Multicentre randomised controlled non-inferiority trial Randomized Peer reviewed |
|---|---|
| Sample size | 249 |
| Population | Adults with recurrent depression in remission who had been using maintenance antidepressant medication for 6 months or longer |
| Interventions | Mindfulness-based cognitive therapy (MBCT) maintenance antidepressant medication (mADM) |
| Duration | 15-month follow-up |
| Topics | Depression Meditation |
| Registration | NCT00928980 |
| Key findings | Discontinuing maintenance antidepressants after MBCT was not non-inferior to continuing them: the difference in relapse/recurrence rates within 15 months exceeded the 25% non-inferiority margin, and time to relapse/recurrence was significantly shorter after discontinuation. Depression severity showed only minor differences between groups. The authors suggest an increased risk of relapse/recurrence in patients withdrawing from maintenance antidepressants after MBCT. |
Abstract
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. To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. 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. 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. Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT.
Comparable studies
Other randomized controlled trials on depression, most cited first.
Citations in the library
Cited by 11
- Mindfulness Interventions Annual Review of Psychology September 30, 2016
- Supporting antidepressant discontinuation using mindfulness plus monitoring versus monitoring alone: A cluster randomized trial in general practice. PLoS One 2023
- Factors associated with relapse and recurrence of major depressive disorder in patients starting mindfulness‐based cognitive therapy Depression and Anxiety November 9, 2021
- Discontinuing antidepressant medication after mindfulness-based cognitive therapy: a mixed-methods study exploring predictors and outcomes of different discontinuation trajectories, and its facilitators and barriers BMJ Open November 12, 2020
- Mindfulness‐based cognitive therapy for prevention and time to depressive relapse: Systematic review and network meta‐analysis Acta Psychiatrica Scandinavica October 9, 2020
and 6 more in the library
Cites 7
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Mindfulness-based cognitive therapy for depression August 21, 2006
- Adding mindfulness-based cognitive therapy to maintenance antidepressant medication for prevention of relapse/recurrence in major depressive disorder: Randomised controlled trial. Journal of Affective Disorders November 15, 2015
- Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial The Lancet July 4, 2015
- The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clinical Psychology Review May 15, 2011
and 2 more in the library