Critical appraisal of evidence for continuing antidepressant therapy beyond 12 months (www1.racgp.org.au)

• No placebo-controlled trials support long-term antidepressant use beyond 12 months.
• Long-term maintenance trials may overestimate benefits due to design flaws.
• Discontinuation should be gradual and patient-centered.

"A paper published in the Australian Journal of General Practice critically appraises the evidence supporting long-term antidepressant use (>12 months). It highlights the lack of robust placebo-controlled trials beyond 12 months and the potential overestimation of benefits. The authors, including Joanna Moncrieff, argue that discontinuation can be considered for many patients, but requires careful tapering. The piece is likely to influence prescribing practices in Australia, where antidepressant use is high."