Selective serotonin reuptake inhibitor treatment in the UK: Risk of relapse or recurrence of depression

Patients with depression are often not prescribed antidepressants for an adequate period of time. The impact of antidepressant prescribing patterns on the risk of relapse or recurrence of depression is examined. The MediPlus UK Primary Care Database was used to identify patients treated for depression with a selective serotonin reuptake inhibitor (SSRI). Records were used to construct hierarchical prescription patterns (less than 120 days, switching/augmentation, upward titration, or stable use) as indicators for the occurrence of relapse or recurrence of depression. Patients with stable use experienced the lowest risk of relapse or recurrence. Factors significantly associated with increased risk include prior use of anxiolytic medications, more comorbid conditions and younger age. The SSRI prescription pattern most consistent with recommended depression treatment guidelines was associated with the lowest risk of relapse or recurrence.