Evidence map›Paper›PMID 37770893›Full record

ArticleTrials2023

RELEASE (REdressing Long-tErm Antidepressant uSE): protocol for a 3-arm pragmatic cluster randomised controlled trial effectiveness-implementation hybrid type-1 in general practice.

Katharine A Wallis, Maria Donald, Mark Horowitz, Joanna Moncrieff, Robert S Ware, Joshua Byrnes, Karen Thrift, MaryAnne Cleetus, Idin Panahi, Nicholas Zwar and 3 more

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
4.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Stopping antidepressants: when and how.Australian prescriber · 2026
    Review
  5. Observational
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 2 countries.

Katharine A WallisGeneral Practice Clinical Unit, Medical School, The University of Queensland, Herston, Brisbane, QLD, 4072, Australia. k.wallis@uq.edu.au.ORCID http://orcid.org/0000-0002-2580-9362
Maria DonaldGeneral Practice Clinical Unit, Medical School, The University of Queensland, Herston, Brisbane, QLD, 4072, Australia.
Mark HorowitzNHS Foundation Trust, Research and Development Department, London, Northeast London, UK.
Joanna MoncrieffUniversity College London, London, UK.
Robert S WareGriffith University, Nathan, Brisbane, QLD, Australia.
Joshua ByrnesGriffith University, Nathan, Brisbane, QLD, Australia.
Karen ThriftGeneral Practice Clinical Unit, Medical School, The University of Queensland, Herston, Brisbane, QLD, 4072, Australia.
MaryAnne CleetusGeneral Practice Clinical Unit, Medical School, The University of Queensland, Herston, Brisbane, QLD, 4072, Australia.
Idin PanahiGeneral Practice Clinical Unit, Medical School, The University of Queensland, Herston, Brisbane, QLD, 4072, Australia.
Nicholas ZwarFaculty of Health Sciences and Medicine, Bond University, Robina, Gold Coast, QLD, Australia.
Mark MorganFaculty of Health Sciences and Medicine, Bond University, Robina, Gold Coast, QLD, Australia.
Chris FreemanThe University of Queensland, Herston, Brisbane, QLD, 4072, Australia.
Ian ScottThe University of Queensland, Herston, Brisbane, QLD, 4072, Australia.
The University of Queensland · AUBond University · AUGriffith University · AUNorth East London NHS Foundation Trust · GBUniversity College London · GB

Funding

Australian Commonwealth Department of Health, Medical Research Future Fund MRFAR000079National Health and Medical Research Council PRC3 - 2015744
6 · The paper itself

Abstract

backgroundMany people experience withdrawal symptoms when they attempt to stop antidepressants. Withdrawal symptoms are readily misconstrued for relapse or ongoing need for medication, contributing to long-term use (> 12 months). Long-term antidepressant use is increasing internationally yet is not recommended for most people. Long-term use is associated with adverse effects including weight gain, sexual dysfunction, lethargy, emotional numbing and increased risk of falls and fractures. This study aims to determine the effectiveness of two multi-strategy interventions (RELEASE and RELEASE+) in supporting the safe cessation of long-term antidepressants, estimate cost-effectiveness, and evaluate implementation strategies.

methods

design3-arm pragmatic cluster randomised controlled trial effectiveness-implementation hybrid type-1.

settingprimary care general practices in southeast Queensland, Australia. POPULATION: adults 18 years or older taking antidepressants for longer than 1 year. Practices will be randomised on a 1.5:1:1 ratio of Usual care:RELEASE:RELEASE+.

interventionRELEASE for patients includes evidence-based information and resources and an invitation to medication review; RELEASE for GPs includes education, training and printable resources via practice management software. RELEASE+ includes additional internet support for patients and prescribing support including audit and feedback for GPs. OUTCOME MEASURES: the primary outcome is antidepressant use at 12 months self-reported by patients. Cessation is defined as 0 mg antidepressant maintained for at least 2 weeks. SECONDARY OUTCOMES: at 6 and 12 months are health-related quality of life, antidepressant side effects, well-being, withdrawal symptoms, emotional numbing, beliefs about antidepressants, depressive symptoms, and anxiety symptoms; and at 12 months 75% reduction in antidepressant dose; aggregated practice level antidepressant prescribing, and health service utilisation for costs. SAMPLE SIZE: 653 patients from 28 practices. A concurrent evaluation of implementation will be through mixed methods including interviews with up to 40 patients and primary care general practitioners, brief e-surveys, and study administrative data to assess implementation outcomes (adoption and fidelity). DISCUSSION: The RELEASE study will develop new knowledge applicable internationally on the effectiveness, cost-effectiveness, and implementation of two multi-strategy interventions in supporting the safe cessation of long-term antidepressants to improve primary health care and outcomes for patients.

trial registrationANZCTR, ACTRN12622001379707p. Registered on 27 October 2022.

Indexed as

General PracticeGeneral PractitionersAdultAntidepressive AgentsCost-Benefit AnalysisHealth ServicesHumansPragmatic Clinical Trials as TopicQuality of LifeRandomized Controlled Trials as TopicAntidepressive AgentsAntidepressantsDeprescribingDiscontinuationLong-term antidepressant usePrimary careRandomised controlled trialTaperingWithdrawal

Identifiers

PMID37770893
PMCPMC10537226
OpenAlexW4387118681

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.