Quality statement 10: Continuing antidepressants

Quality statement

People with depression who benefit from treatment with antidepressants are advised to continue with treatment for at least 6 months after remission, extending to at least 2 years for people at risk of relapse.

Quality measure

Structure: Evidence of local arrangements for monitoring and reviewing people prescribed antidepressants.

Process:

a) Proportion of people with depression benefiting from antidepressants who remain on them at least 6 months after remission.

Numerator – the number of people in the denominator remaining on antidepressants at least 6 months after remission.

Denominator – the number of people with depression benefiting from antidepressants.

b) Proportion of people with depression benefiting from antidepressants and at risk of relapse who remain on them 2 years after remission.

Numerator – the number of people in the denominator remaining on antidepressants 2 years after remission.

Denominator – the number of people with depression benefiting from antidepressants and at risk of relapse.

What the quality statement means for each audience

Service providers ensure systems are in place for monitoring and reviewing all people with depression prescribed antidepressants.

Healthcare professionals ensure people with depression benefiting from antidepressants are advised to continue with treatment for at least 6 months, extending to at least 2 years for people at risk of relapse.

Commissioners ensure they commission services that monitor compliance with antidepressant medication.

People with depression who are feeling better after taking antidepressants are advised to keep taking them for at least 6 months, and for up to at least 2 years if their symptoms are likely to return.

Definitions

The term 'people with depression' includes all people with depression and a chronic physical health problem.

The level of medication at which acute treatment was effective should be maintained for at least 2 years (unless there is good reason to reduce the dose, such as unacceptable adverse effects) if:

  • they have had two or more episodes of depression in the recent past, during which they experienced significant functional impairment

  • they have other risk factors for relapse such as residual symptoms, multiple previous episodes, or a history of severe or prolonged episodes or of inadequate response

  • the consequences of relapse are likely to be severe (for example, suicide attempts, loss of functioning, severe life disruption and inability to work).

Source guidance

NICE clinical guideline 90 recommendations 1.9.1.1 (key priority for implementation) and 1.9.1.4.

Data source

Structure: Local data collection.

Process: Local data collection.