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The University of Southampton
Southampton Clinical Trials Unit

REDUCE

Trial Name

REDUCE - REVIEWING LONG TERM ANTIDEPRESSANT USE BY CAREFUL MONITORING IN EVERYDAY PRACTICE

Description

There is considerable concern about increasing antidepressant use in England. GPs are writing more than 60 million prescriptions a year, to around 1-in-10 adults. Some people need long-term antidepressants to stop them getting depressed, but a third-to-a-half could possibly stop them without relapsing. Taking antidepressants long-term exposes patients to the risks of side-effects. People taking antidepressants report their GPs rarely review them and just give repeat prescriptions. Studies show that when GPs do review patients on long-term antidepressants and recommend that they could begin to stop taking them, only 1-in-14 is able to stop. Patients can be fearful and cessation can be tricky, so GPs and Nurse Practitioners (NPs) who prescribe antidepressants need to develop individual cessation strategies for each patient, and be able to offer them sustained support, especially in the first few weeks or months. The REDUCE research programme aims to identify feasible, safe, effective, and cost-effective ways of helping patients taking long-term antidepressants taper off and stop treatment, when appropriate.

Objectives

  1. Conduct a systematic review of interventions used to help patients successfully stop antidepressant treatment.
  2. Identify factors promoting or inhibiting treatment cessation, through interviews with patients, and focus groups with practitioners.
  3. Develop an internet-supported CBT-based intervention to support treatment tapering and cessation, through co-design and co-production with practitioners and patients.
  4. Determine the effectiveness of the intervention through a randomised controlled trial, and estimate cost-effectiveness from a health/social service perspective.
  5. Build a translational framework addressing how the intervention should be delivered, including overcoming practitioner and patient related barriers, to facilitate implementation. 

Design

The REDUCE Programme consists of five work streams (WS):

Population

Patients who are taking long-term antidepressant treatment, including:

Potential participants will be approached in two ways:

Contacts

Sponsor: University of Southampton

Chief Investigator: Professor Tony Kendrick

Programme Manager: Wendy O’Brien

Stufy Coordinator: Dr Hannah Bowers

Email: reduce@soton.ac.uk 

REDUCE Website

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