vida: extract claims from 2025-12-xx-lancet-psychiatry-antidepressant-deprescribing-nma-slow-taper-therapy

- Source: inbox/queue/2025-12-xx-lancet-psychiatry-antidepressant-deprescribing-nma-slow-taper-therapy.md
- Domain: health
- Claims: 1, Entities: 0
- Enrichments: 0
- Extracted by: pipeline ingest (OpenRouter anthropic/claude-sonnet-4.5)

Pentagon-Agent: Vida <PIPELINE>

domains/health/antidepressant-discontinuation-follows-continuous-treatment-model-but-psychological-support-mitigates-relapse.md

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+---
+type: claim
+domain: health
+description: Psychiatric pharmacotherapy shows the same benefit-reversion pattern as metabolic drugs but has a mitigation pathway through behavioral intervention that metabolic treatments lack
+confidence: likely
+source: The Lancet Psychiatry, network meta-analysis of 76 RCTs with 17,000+ adults
+created: 2026-04-11
+title: "Antidepressant discontinuation follows a continuous-treatment model with 45% relapse by 12 months but slow tapering plus psychological support achieves parity with continued medication"
+agent: vida
+scope: causal
+sourcer: The Lancet Psychiatry
+related_claims: ["[[GLP-1 receptor agonists are the largest therapeutic category launch in pharmaceutical history but their chronic use model makes the net cost impact inflationary through 2035]]"]
+---
+
+# Antidepressant discontinuation follows a continuous-treatment model with 45% relapse by 12 months but slow tapering plus psychological support achieves parity with continued medication
+
+Network meta-analysis of 76 randomized controlled trials with over 17,000 adults in clinically remitted depression shows that antidepressant discontinuation follows a continuous-treatment pattern: relapse rates reach 34.81% at 6 months and 45.12% at 12 months after discontinuation. However, slow tapering (>4 weeks) combined with psychological support achieves equivalent relapse prevention to remaining on antidepressants (relative risk 0.52; NNT 5.4). This reveals a critical structural difference from metabolic interventions like GLP-1 agonists: psychiatric pharmacotherapy can be partially substituted by behavioral/cognitive interventions during discontinuation, while metabolic treatments show no such mitigation pathway. Abrupt discontinuation shows clearly higher relapse risk, confirming the continuous-treatment pattern, but the effectiveness of gradual tapering plus therapy demonstrates that the durability profile of interventions differs by mechanism—behavioral interventions can create lasting cognitive/emotional skills that reduce relapse risk, while metabolic interventions address physiological states that fully revert without ongoing treatment. The finding that continuation plus psychological support outperformed abrupt discontinuation (RR 0.40; NNT 4.3) while slow taper plus support matched continuation suggests psychological support is the active ingredient enabling safe discontinuation, not merely time-based tapering.