Ongoing research aims to reduce antidepressant use

Mental health-related issues remain the number one reason people visit their GP in Australia.
 
It is therefore not surprising that Australia has one of the highest rates of antidepressant use in the world, with usage increasing in the past decade. Australian Bureau of Statistics data showed that around 8% of the population had at least one antidepressant prescription filled in 2011.
 
Professor Jane Gunn, GP, Chair of Primary Care Research and Deputy Dean, Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne, believes that one of the barriers for people ceasing antidepressants is that many people continue for longer than they need to, and often don’t know when or even how to stop.
 
‘As Australians, we are large consumers of antidepressants – one of the largest groups of users worldwide. Whilst we have good resources to assist with commencing antidepressants, we do not have resources to support GPs and patients to decide whether and when to cease using antidepressants,’ she told newsGP.  
 
This background helped form the impetus for Professor Gunn’s initial research, for which she received a joint grant from the RACGP Foundation and Therapeutic Guidelines. The research provided preliminary results that led to further funding from the National Health and Medical Research Council (NHMRC) for 2019–24.
 
The NHMRC project is the implementation of STOPS: A randomised trial of a STructured Online intervention to Promote and Support antidepressant de-prescribing in primary care.
 
‘The findings from this study have informed an intervention which is being developed for testing in a randomised controlled trial,’ she said.
 
‘We have developed an online program to help people stop [taking antidepressants] when their GP says it’s okay to do so.
 
‘This project will test whether our program can help people cease their antidepressant use safely and successfully, thereby reducing costs and adverse health impacts.’
 
The research team developed an intervention to assist patients and GPs to make decisions about whether it was safe to cease antidepressants, when to cease, and how. Collaboration with GPs and patients who were long-term users assisted in the design concept for the intervention.
 
Professor Gunn hopes the STOPS project will inform GPs and other primary healthcare providers in their management of antidepressants, as well as monitoring usage and over-prescribing.
 
‘We are delighted to have been successful in gaining funding from NHMRC for a five-year study testing whether the STOPS intervention is effective, which will keep us very busy building the evidence base to assist GPs and patients with their decision making around long-term antidepressant use,’ Professor Gunn said.
 
‘There is emerging evidence that long-term use of antidepressants may be associated with poorer health outcomes for some, making the decision around cessation even more important.
 
‘It is vital that we build a strong evidence base to guide our practice, as starting and stopping medications are decisions that impact greatly on our lives and should not be made lightly.’

Applications for the 2019 RACGP Foundation Research Grants have now closed – the recipients will be announced during the first week of August. Grant applications for 2020 open in March next year.

antidepressants de-prescribing NHMRC RACGP Foundation research