The role of trauma, attachment, and voice-hearer’s appraisals: a latent profile analysis in the AVATAR2 trial
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Authors
Marotti, J.
Saunders, R.
Montague, A.
Fornells-Ambrojo, M
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Issue Date
27/02/2025
Type
Journal Article
Language
Keywords
Mental Health
Alternative Title
Abstract
The Editorial by Looi and colleagues provided a one-sided view of the need to consider deprescribing antidepressants in Australia. They overlooked clear evidence that at least a third of patients no longer meet criteria for ongoing use of antidepressants – this would mean a million people in Australia. They minimised the harms of antidepressants and over-emphasised their benefits in the long term. In addition to this, the authors mis-characterised the Maudsley Deprescribing Guidelines as advocating deprescribing antidepressants even when patients do not wish to stop them or when there is clear benefit. The aim of the Maudsley Deprescribing Guidelines is to give advice on how to stop antidepressants safely in situations where it is in a patient’s best interest.
Introduction
We wish to reply to the editorial by Looi et al.1 We are glad that the authors agree that hyperbolic tapering is the most sensible approach to deprescribing antidepressants. However, they minimise evidence of overprescribing and misrepresent aspects of the Maudsley Deprescribing Guidelines.2 The editorial erroneously characterises the Maudsley Deprescribing Guidelines as advocating ‘population-level deprescribing of antidepressants’, – deprescribing even when against the wishes of the patient (as in cases where ‘patients maintain a preference for medication’) or where patients ‘are benefiting’. In fact, the book offers guidance on how to stop antidepressants in a safe manner when this is in the best interests of the patient and when they agree to the process through shared decision-making. It does not advocate deprescribing for those benefiting from medication or those who wish to continue it.
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Citation
Psychological Medicine. 2025;55:e65. doi:10.1017/S003329172500008X
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Journal
Psychological Medicine
Volume
55