Can Some Patients Successfully Discontinue SSRIs?
To the Editor: Pundiak et al1 found that patients who had had a 50% reduction in their Montgomery-Asberg Depression Rating Scale (MADRS) scores but were still scoring 5 to 14 were roughly 5 times more likely to relapse than those who had achieved a MADRS score of 1 to 4. One might classify the latter group "well"; the former, "improved but still symptomatic" and perhaps able to benefit from more intensive treatment, without which relapse is highly likely.
The authors do not show their data in enough detail for the reader to determine whether the "well" group was better able to discontinue medication; this would be interesting to know.
I am also curious about whether their "terminated well" group is a group who terminated their medications after the beginning of the study period and then remained well; if so, what were their MADRS scores like?
References
1. Pundiak TM, Case BG, Peselow ED, et al. Discontinuation of maintenance selective serotonin reuptake inhibitor monotherapy after 5 years of stable response: a naturalistic study. J Clin Psychiatry. 2008;69(11):1811-1817. PubMed
Author affiliation: Private practice; Sherborn, Massachusetts. Financial disclosure: None reported. Funding/support: None reported.
doi:10.4088/JCP.09lr05006blu
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