Table 1.
Results of mixed effect meta-analysis and mixed effect subgroup analyses of studies on relapse after discontinuation of antidepressants in anxiety disorders
| Meta-analysis/subgroup analysis | References | No of studies | Odds ratio (95% CI)* | Q | I2 | DF (Q) | P value |
|---|---|---|---|---|---|---|---|
| Relapse | 28 | 3.11 (2.48 to 3.89) | 29.37 | 8.07 | 27 | ||
| Anxiety DSM-IV: | 28 | 3.03 (2.44 to 3.78) | 30.24 | 10.73 | 4 | 0.29 | |
| Generalised anxiety disorder | 24, 48, 54-57 | 6 | 4.20 (2.42 to 7.28) | 6.26 | 20.11 | 5 | |
| Obsessive-compulsive disorder | 50, 58-63 | 7 | 2.43 (1.74 to 3.38) | 2.32 | 0 | 6 | |
| Panic disorder | 42, 51, 64-67 | 6 | 2.88 (1.37 to 6.03) | 5.47 | 8.59 | 5 | |
| Post-traumatic stress disorder | 41, 53, 68, 69 | 4 | 2.45 (0.86 to 6.97) | 3.21 | 6.50 | 3 | |
| Social phobia | 52, 70-73 | 5 | 3.19 (1.02 to 9.95) | 8.61 | 53.56 | 4 | |
| Anxiety DSM-5: | 17 | 3.55 (2.53 to 4.98) | 19.92 | 19.67 | 2 | 0.58 | |
| Generalised anxiety disorder | 24, 48, 54-57 | 6 | 4.21 (2.40 to 7.37) | 5.45 | 8.19 | 5 | |
| Panic disorder | 42, 51, 64-67 | 6 | 2.92 (1.37 to 6.22) | 5.10 | 1.96 | 5 | |
| Social phobia | 52, 70-73 | 5 | 3.17 (0.97 to 10.40) | 8.12 | 50.74 | 4 | |
| Antidepressant: | 28 | 3.33 (2.65 to 4.17) | 29.14 | 7.34 | 2 | 0.25 | |
| SSRI | 41, 42, 50-55, 58-61, 63, 66-73 | 21 | 2.86 (2.17 to 3.78) | 20.73 | 3.54 | 20 | |
| SNRI | 24, 48, 65 | 3 | 5.03 (1.31 to 19.40) | 2.19 | 8.62 | 2 | |
| Other | 56, 57, 62, 64 | 4 | 2.92 (1.03 to 8.23) | 3.20 | 6.14 | 3 | |
| Discontinuation: | 28 | 3.05 (2.44 to 3.81) | 32.16 | 16.03 | 1 | 0.10 | |
| Abrupt | 50, 51, 56, 57, 59, 60, 66-68, 70, 73 | 11 | 2.52 (1.80 to 3.52) | 8.60 | 0 | 10 | |
| Taper | 24, 41, 42, 48, 52-55, 58, 61-65, 69, 71, 72 | 17 | 3.61 (2.60 to 5.02) | 20.69 | 22.66 | 16 | |
| Concurrent psychotherapy allowed: | 28 | 3.17 (2.54 to 3.95) | 32.44 | 16.78 | 1 | 0.10 | |
| No | 50, 53, 56-63, 65, 68-70, 73 | 15 | 2.64 (2.06 to 3.37) | 9.69 | 0 | 14 | |
| Yes | 24, 41, 42, 48, 51, 52, 54, 55, 64, 66, 67, 71, 72 | 13 | 3.86 (2.49 to 5.98) | 19.45 | 38.30 | 12 | |
| Comorbidity mostly excluded: | 28 | 3.11 (2.45 to 3.93) | 29.87 | 9.62 | 1 | 0.62 | |
| No | 41, 42, 59, 60, 63, 64, 66, 68, 71, 73 | 10 | 2.82 (1.74 to 4.57) | 8.21 | 0 | 9 | |
| Yes | 24, 48, 50-58, 61, 62, 65, 67, 69, 70, 72 | 18 | 3.20 (2.37 to 4.32) | 21.42 | 20.63 | 17 |
DSM=Diagnostic and Statistical Manual of Mental Disorders; SNRI=serotonin-noradrenalin reuptake inhibitor; SSRI=selective serotonin reuptake inhibitor.
*All confidence intervals are Hartung-Knapp-Sidik-Jonkman adjusted.