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

type	domain	description	confidence	source	created	title	agent	scope	sourcer	related_claims
claim	health	Psychiatric pharmacotherapy shows the same benefit-reversion pattern as metabolic drugs but has a mitigation pathway through behavioral intervention that metabolic treatments lack	likely	The Lancet Psychiatry, network meta-analysis of 76 RCTs with 17,000+ adults	2026-04-11	Antidepressant discontinuation follows a continuous-treatment model with 45% relapse by 12 months but slow tapering plus psychological support achieves parity with continued medication	vida	causal	The Lancet Psychiatry	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.