Following the publication of the REDUCE trial by Kendrick et al a number of clarifications and questions were asked on social media in relation to the study design, the conclusions made and the key messages that the study team have since helped disseminate to the general public.
The University of Southampton shared on social media:
and shared this by Prof Tony Kendrick who led the REDUCE trial:
It is most welcome that 40% of those involved in the REDUCE Trial were able to stop antidepressants. It is surprising however that in the media reporting of this trial, equal weight was not been given to the 60% who were unable to stop antidepressants.
The following exchanges, all from social media, reflect some of the subsequent discussion which included some of the other evidence in this area:
Professor Tony Kendrick, 6 July 2024: “Withdrawal symptoms were measured and accounted for in the ANTLER placebo controlled trial of discontinuing long term antidepressants and did not negate the findings of an increased risk of relapse. Not everyone can come off medication without getting depressed.”
Dr Mark Horowitz, 6 July 2024: “This is false. Antidepressant withdrawal symptoms were measured and NOT accounted for in the Antler trial. No patients were excluded for having withdrawal symptoms mis-classified as relapse. And no study has been published from the withdrawal data almost 3 years later.”
Professor Tony Kendrick, 6 July 2024: “You have made up that suggestion about REDUCE. And to suggest that not being able to come off long-term antidepressants is a failure is to deny the placebo-controlled trial evidence that more than half of people relapse on stopping them. Half the people need them to stay well.”
Dr Mark Horowitz, 6 July 2024: “You have a group of remarkably well people, most people don’t have recurrent disorders, 40% had no previous depressive episodes. They wanted to stop so not stopping is a failure. Relapse as the explanation possible but unlikely.”
Professor Tony Kendrick, 7 July 2024: “We provided hyperbolic tapering schedules in REDUCE for people who had difficulty with withdrawal symptoms. It still wasn’t possible to get everyone off their antidepressants. A proportion of people need them to avoid relapse.”
Professor Tony Kendrick, 7 July 2024: “Stop blaming people who need long term treatment to remain well.”
Professor Tony Kendrick, 7 July 2024:
Professor Tony Kendrick, 9 July 2024 to Dr Peter C. Groot:
A few personal thoughts:
I am not an expert in trials. However, it seemed obvious to me that the absence of comment on the people who could not come off antidepressants [60%] in the media reporting of the REDUCE trial wasn’t balanced. The response to the questions subsequently raised needs to be professional and not defensive.