Netherlands study of Optimal, Personal Antidepressant use

Over 1 million Dutch people currently get an antidepressant prescribed, with depression as the main indication. Although the effectiveness of antidepressant medication in the treatment of depression is well-established, the response to antidepressant medications varies. In order to personalize antidepressant treatment and improve response rates, increased knowledge on (predictors of) remission are needed. Furthermore, there is limited knowledge about discontinuation of antidepressant medications.

The aims of this study are to investigate:

the course and predictors of remission in depressed adults that recently started with antidepressants
the course of antidepressant treatment (e.g. discontinuation) in depressed adults that recently started with antidepressants.
OPERA is coordinated by the departments of primary care and psychiatry of 5 University medical centers throughout the Netherlands (Amsterdam UMC location VUmc, UMC Groningen, RadboudUMC, Erasmus MC, Leiden UMC), and collaborates with general practitioners, psychiatrists, pharmacists, patient organizations and professional organizations.

OPERA consists of two parts. The first part is OPERA-monitor. In OPERA-monitor, 950 patients with depression (18-75 year) that recently started with antidepressant medication (for this study citalopram or sertraline) will be invited to complete bi-monthly online questionnaires to monitor depressive symptoms. Participants for the OPERA-monitor cohort will be recruited in general practices, specialized mental health care facilities and pharmacies. The second part is OPERA-discontinuation: a multi-center double-blind randomized clinical trial in which patients were randomly allocated to an early discontinuation vs. later discontinuation group. The OPERA-discontinuation study was terminated at an early stage because the inclusion rate of the trial was too low. Fewer people than expected met the inclusion criteria for the trial and reached stable depression remission.

OPERA-monitor started in 2019 and will continue until 2023. OPERA is supported by The Netherlands Organization for Health Research and Development (ZonMW; grant number 848040001), and by the participating University Medical Centers.

Contact: dr. Mariska Bot, project coordinator (opera@vumc.nl).

OPERA-monitor
Antidepressiva zijn medicijnen die goed kunnen werken tegen een depressie. De werkzaamheid kan echter erg verschillen tussen mensen. Sommige mensen die antidepressiva gebruiken, herstellen volledig van hun depressie, terwijl anderen nog last houden van depressieve klachten. Het is nog niet goed te voorspellen wie zal opknappen met antidepressiva en hoelang dat duurt.

Met het OPERA-monitor onderzoek willen we antwoord geven op de volgende vragen:

Hoe lang duurt het voordat iemand herstelt van een depressie na het starten met een antidepressivum?
Zijn er kenmerken die bepalen of mensen beter of sneller herstellen? En welke kenmerken zijn dit?
Wat zijn de ervaringen met het stoppen van antidepressivagebruik?
Dit doen we door bij mensen die antidepressiva gebruiken vanwege hun depressie, nauwkeurig in kaart te brengen hoe het herstel verloopt. Hiermee kunnen we in de toekomst patiënten beter voorlichten over het slikken van antidepressiva.