UChicago Medicine Primary Care e-Journal Club: Maintenance or Discontinuation of Antidepressants in Primary Care

February 1, 2022 to February 28, 2022
This activity will use an asynchronous e-learning model to facilitate engagement of with high-impact updates in the primary care literature that will improve patient care.
This article describes the results of ANTLER which was a randomized double-blind trial comparing the effect of treatment maintenance versus treatment discontinuation in adults with depression receiving common antidepressants for more than 9 months in a primary care setting.
This multi-center trial was conducted in the United Kingdom and enrolled 478 patients who had been all been taking antidepressants for at least 9 months and felt well enough to stop. The patients were majority female with mean age in the 50s, were almost exclusively white and typically had experienced 3 or more prior episodes of depression. Baseline mean PHQ9 scores were 3.9 in the maintenance group and 3.8 in the discontinuation group. The patients included those taking citalopram, sertraline, fluoxetine, and mirtazipine (escitalopram is not commonly prescribed in the UK).
During the 52-week trial depression relapse occurred in 39% of the maintenance group and 56% of the discontinuation group with a hazard ratio of 2.06 (95% confidence interval 1.56-2.70). By the end of the trial 39% of the patients in the discontinuation group had returned to taking antidepressant medication (prescribed outside of the study).

Target Audience

This activity is designed for physicians and other healthcare professionals that provide primary care to patients at UChicago Medicine.

Learning Objectives

At the conclusion of this activity, participants will be able to:

  • Compare continuation with tapering for antidepressants for the treatment of chronic depression in primary care;
  • Discuss differences between study population and personal clinical practice;
  • Reflect on personal experience with treatment of chronic depression.
Additional information
ACGME/ABMS Core Competencies: 
Patient Care and Procedural Skills
Medical Knowledge
For more information, please contact:
CME Coordinator Contact Name: 
Katherine Sullivan
CME Coordinator Contact Email: 
CME Coordinator Contact Phone: 
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Participation
Event starts: 
02/01/2022 - 12:00am
Event ends: 
02/28/2022 - 11:59pm
Activity opens: 
Activity expires: 
  George Weyer, MD
  Assistant Professor of Medicine
  The University of Chicago




Disclosure Declarations
As a provider accredited by the ACCME, The University of Chicago Pritzker School of Medicine asks everyone in a position to control the content of an education activity to disclose all financial relationships with any ineligible companies. This includes any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients. Financial relationships are relevant if a financial relationship, in any amount, exists between the person in control of content and an ineligible company during the past 24 months, and the content of the education is related to the products of an ineligible company with whom the person has a financial relationship. Mechanisms are in place to identify and mitigate any relevant financial relationships prior to the start of the activity.

Additionally, The University of Chicago Pritzker School of Medicine requires Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration at first mention and where appropriate in the content.

Physician Credit
The University of Chicago Pritzker School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The University of Chicago Pritzker School of Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Other Healthcare Professional Credit
Other healthcare professionals will receive a Certificate of Participation. For information on the applicability and acceptance of Certificates of Participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME, please consult your professional licensing board.
Please Note: The credit claiming process will close three months after the conference end date. Requests to claim credit after three months will be subject to additional fees.
Registration: This course is only open to University of Chicago affiliates.
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