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GP review and hyperbolic tapering guidance increases antidepressant cessation rate to 14.9% at 12 monthsNew approach helps some patients stop taking antidepressants safely

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Key Takeaway
Consider GP review and hyperbolic tapering guidance to support antidepressant cessation or dose reduction in general practice.

This cluster randomized controlled trial evaluated an intervention involving an invitation to a general practitioner (GP) review combined with resources for shared decision-making and hyperbolic tapering guidance. The study included 483 adults who had been taking antidepressants for more than 12 months in an Australian general practice setting.

The primary outcome was cessation at 12 months. The intervention group showed a cessation rate of 14.9% (32 of 215) compared to 8.6% (16 of 187) in the usual care group (OR = 1.95; 95%CI, 1.00 to 3.81; p=0.050). Secondary outcomes included a higher rate of cessation at 6 months in the intervention group (11.7% vs 4.8%; OR = 2.68) and a higher rate of dose reductions exceeding 75% at 12 months (19.6% vs 9.9%; OR = 2.28).

Symptom scores for depression, anxiety, and withdrawal were similar between the intervention and usual care groups. No adverse events were attributed to the intervention. A primary limitation of the study is the small absolute cessation rates in both groups. The findings suggest that structured GP reviews and tapering guidance may support patients seeking to reduce or stop antidepressants, though the statistical significance for the primary outcome was at the threshold.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in clinical management for patients on long-term antidepressant therapy. While previous coverage highlighted digital interventions like eMPower and ICBT as effective for reducing anxiety and depression symptoms, this study specifically evaluates a structured clinical pathway to facilitate medication tapering and cessation.

Many people who take antidepressants for long periods feel uncertain about how or when to stop. A study of 483 adults in Australia looked at a specific way to help these patients. Instead of standard care, some patients received an invitation for a doctor review along with special tools to help them and their doctors make shared decisions about tapering off their medication slowly.

The results showed that more people in the guided group stopped their medication after 12 months compared to those receiving usual care. While the overall number of people who successfully stopped was still modest, the guided approach also led to more patients significantly reducing their doses by over 75%.

Importantly, the study found no difference in symptoms for depression, anxiety, or withdrawal between the two groups. This suggests that the extra support from a doctor and specific tapering guidance can help people manage the transition off medication without making their symptoms worse. Because the results were right on the edge of being statistically certain, it is an encouraging step forward for personalized care.

What this means for you:
Guided doctor reviews and tapering plans can help more patients successfully reduce or stop antidepressants.

Common questions

How does this method differ from standard care?

Instead of usual care, patients received an invitation for a general practitioner review and specific resources to guide them through tapering. Tapering means slowly reducing the dose of medication over time. This guided approach helped more people stop their antidepressants after 12 months compared to those in the standard group.

Are there side effects or risks involved with this new method?

The study reported no adverse events that were linked to the specific intervention of using a doctor review and tapering guidance. However, it is important to talk to your own doctor before making any changes to your medication plan.

Does this help with withdrawal symptoms?

The study found that scores for depression, anxiety, and withdrawal symptoms were similar between both groups. This means the guided tapering method helped people stop their medication without causing a significant increase in withdrawal symptoms compared to standard care.

Study Details

Study typeRct
Sample sizen = 483
EvidenceLevel 2
PublishedAug 2026
View Original Abstract ↓
BACKGROUND Safe and effective antidepressant deprescribing strategies are needed in general practice where most antidepressant prescribing occurs. METHODS We conducted a pragmatic, cluster-randomised controlled trial in general practice to test invitation to general practitioner (GP) review combined with resources to inform shared decision-making and guide hyperbolic tapering for stopping antidepressants compared to usual care. Adults taking antidepressants for longer than 12 months were recruited from 26 Australian GP practices between March 2023 and November 2024, irrespective of their intention to stop or depression or anxiety symptom scores. The primary outcome was cessation at 12 months. Secondary outcomes included cessation at 6 months, and >75% dose reduction and depression, anxiety and withdrawal symptom scores at 6 and 12 months. RESULTS Overall, 483 patients were randomised. Mean age was 50 years; 73% were women; mean duration of antidepressant use was 14.1 years. Cessation at 12 months was observed in 32 of 215 (14.9%) intervention and 16 of 187 (8.6%) usual care patients (odds ratio (OR) = 1.95 [95%CI, 1.00 to 3.81]; p=0.050). Cessation at 6 months was observed in 11.7% intervention vs 4.8% usual care (OR = 2.68; 95%CI, 1.18 to 6.05), and >75% dose reduction at 12 months in 19.6% intervention vs 9.9% usual care (OR = 2.28; 95%CI, 1.20 to 4.31). Symptom scores were similar between groups. No adverse events were attributable to the intervention. CONCLUSIONS In general practice, invitation to GP antidepressant review combined with information and guidance on hyperbolic tapering can support cessation or dose reduction without causing adverse effects or relapse. Absolute cessation rates were modest but still meaningful given the high prevalence of long term antidepressant use. TRIAL REGISTRATION ANZCT registry identifier, ACTRN12622001379707p.
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