About this trial
In Belgium, many adults who have suffered from depression keep using antidepressants on a daily basis for years afterwards, sometimes longer than guidelines recommend. Yet for some people who have been feeling well for a long time, this is no longer necessary, while the continued use of antidepressants can lead to side effects and causes additional costs for the healthcare system.
However, reducing the doses of antidepressants or stopping altogether is not always easy. Some patients are afraid that their depression will return, and GPs and pharmacists often find the subject difficult to broach.
This is why the GPS-AD study is investigating a new approach in which GPs and pharmacists work more closely together to provide better support to patients. First, the GP invites patients who have been taking antidepressants for a long time for a consultation. Together, they discuss whether tapering of the medication is reasonable and feasible. If they agree to stop the treatment, the GP draws up a tapering plan tailored to the patient. The pharmacist helps monitor this process, offering advice and support to the patient while the doses are gradually reduced.
The study will extend over a period of two years and will take place in GP practices throughout Belgium. The new approach based on closer collaboration between GPs and pharmacists will be compared to the current standard of care, to determine whether it helps more long-term users to stop taking antidepressants without experiencing a recurrence of depressive symptoms.
The name of the study, GPS-AD (General Practitioner and Pharmacist Support for Antidepressant Discontinuation), refers to the collaboration between GPs and pharmacists in tapering of antidepressants, and also symbolises the support and guidance (the 'GPS') provided to patients and healthcare providers in assessing whether long-term use of antidepressants is still necessary.
Eligibility criteria
Qualifiers
Are 18 years or older and capable of providing informed consent.
Have their Global Medical File (GMD) managed by one of the participating GPs.
at least 6 months of continuous daily use following a first depressive episode, or
at least 2 years of continuous daily use in the context of a relapsed depression/recurrent episode
Disqualifiers
AD discontinuation is considered contra-indicated by the treating GP.
Current significant depressive symptoms, defined as a score of ≥12 on the PHQ-9
Current significant anxiety symptoms, defined as a score of ≥10 on the Generalised Anxiety Disorder-7 (GAD-7) scale.
Current suicidal ideation, defined as a score >0 on item 9 (suicidality) of the PHQ-9.
Trial design
Treatments tested in this trial
- GPS-AD intervention
Treatment groups
Locations
Sponsors and collaborators
University Ghent
Lead sponsor
University of Liege
Collaborator
Université Catholique de Louvain
Collaborator
Université Libre de Bruxelles
Collaborator
KU Leuven
Collaborator
Universiteit Antwerpen
Collaborator
VUB
Collaborator