Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial

Marloes J. Huijbers; Philip Spinhoven; Jan Spijker; Henricus G. Ruhé; Digna J. F. van Schaik; Patricia van Oppen; Willem A. Nolen; Johan Ormel; Willem Kuyken; Gert Jan van der Wilt; Marc B. J. Blom; Aart H. Schene; A. Rogier; T. Donders; Anne E. M. Speckens

doi:https://doi.org/10.1192/bjp.bp.115.168971

Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial

Marloes J. Huijbers, Philip Spinhoven, Jan Spijker, Henricus G. Ruhé, Digna J. F. van Schaik, Patricia van Oppen, Willem A. Nolen, Johan Ormel, Willem Kuyken, Gert Jan van der Wilt, Marc B. J. Blom, Aart H. Schene, A. Rogier, T. Donders, Anne E. M. Speckens

Research output: Contribution to journal › Article › Academic › peer-review

50 Citations (Scopus)

Abstract

Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov:NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n= 249), were randomly allocated to either discontinue (n= 128) or continue (n= 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity. The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity. Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT

Original language	English
Pages (from-to)	366-373
Journal	British journal of psychiatry
Volume	208
Issue number	4
DOIs	https://doi.org/10.1192/bjp.bp.115.168971
Publication status	Published - Apr 2016

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Huijbers, M. J., Spinhoven, P., Spijker, J., Ruhé, H. G., van Schaik, D. J. F., van Oppen, P., Nolen, W. A., Ormel, J., Kuyken, W., van der Wilt, G. J., Blom, M. B. J., Schene, A. H., Rogier, A., Donders, T., & Speckens, A. E. M. (2016). Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial. British journal of psychiatry, 208(4), 366-373. https://doi.org/10.1192/bjp.bp.115.168971

@article{181e8bd2d80345a5b6696c28a3e35c74,

title = "Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial",

abstract = "Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov:NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n= 249), were randomly allocated to either discontinue (n= 128) or continue (n= 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity. The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity. Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT",

author = "Huijbers, {Marloes J.} and Philip Spinhoven and Jan Spijker and Ruh{\'e}, {Henricus G.} and {van Schaik}, {Digna J. F.} and {van Oppen}, Patricia and Nolen, {Willem A.} and Johan Ormel and Willem Kuyken and {van der Wilt}, {Gert Jan} and Blom, {Marc B. J.} and Schene, {Aart H.} and A. Rogier and T. Donders and Speckens, {Anne E. M.}",

year = "2016",

month = apr,

doi = "https://doi.org/10.1192/bjp.bp.115.168971",

language = "English",

volume = "208",

pages = "366--373",

journal = "British journal of psychiatry",

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publisher = "Royal College of Psychiatrists",

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Huijbers, MJ, Spinhoven, P, Spijker, J, Ruhé, HG , van Schaik, DJF , van Oppen, P, Nolen, WA, Ormel, J, Kuyken, W, van der Wilt, GJ, Blom, MBJ, Schene, AH, Rogier, A, Donders, T & Speckens, AEM 2016, 'Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial', British journal of psychiatry, vol. 208, no. 4, pp. 366-373. https://doi.org/10.1192/bjp.bp.115.168971

Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial. / Huijbers, Marloes J.; Spinhoven, Philip; Spijker, Jan et al.
In: British journal of psychiatry, Vol. 208, No. 4, 04.2016, p. 366-373.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: randomised controlled non-inferiority trial

AU - Huijbers, Marloes J.

AU - Spinhoven, Philip

AU - Spijker, Jan

AU - Ruhé, Henricus G.

AU - van Schaik, Digna J. F.

AU - van Oppen, Patricia

AU - Nolen, Willem A.

AU - Ormel, Johan

AU - Kuyken, Willem

AU - van der Wilt, Gert Jan

AU - Blom, Marc B. J.

AU - Schene, Aart H.

AU - Rogier, A.

AU - Donders, T.

AU - Speckens, Anne E. M.

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N2 - Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov:NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n= 249), were randomly allocated to either discontinue (n= 128) or continue (n= 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity. The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity. Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT

AB - Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. To investigate whether MBCT with discontinuation of mADM is non-inferior to MBCT+mADM. A multicentre randomised controlled non-inferiority trial (ClinicalTrials.gov:NCT00928980). Adults with recurrent depression in remission, using mADM for 6 months or longer (n= 249), were randomly allocated to either discontinue (n= 128) or continue (n= 121) mADM after MBCT. The primary outcome was depressive relapse/recurrence within 15 months. A confidence interval approach with a margin of 25% was used to test non-inferiority. Key secondary outcomes were time to relapse/recurrence and depression severity. The difference in relapse/recurrence rates exceeded the non-inferiority margin and time to relapse/recurrence was significantly shorter after discontinuation of mADM. There were only minor differences in depression severity. Our findings suggest an increased risk of relapse/recurrence in patients withdrawing from mADM after MBCT

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DO - https://doi.org/10.1192/bjp.bp.115.168971

M3 - Article

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SN - 0007-1250

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JO - British journal of psychiatry

JF - British journal of psychiatry

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