Risk of relapse of anxiety disorder after medication discontinuation

Anxiety disorders are typically chronic or episodic; however, the optimal duration of continuation treatment is not established.

A meta-analysis of 28 relapse-prevention studies (n=5,233) including studies of people with GAD, panic disorder, social phobia, OCD, and PTSD, found that:

• Antidepressant discontinuation increased the risk of relapse:
  OR: 3.11 (95% CI 2.48, 3.89)
  • Relapse rate for placebo: 36.4% (95% CI: 30.8, 42.1)
  • Relapse rate for active treatment: 16.4% (95% CI:12.6, 20.1)
  • The time to relapse was shorter after treatment discontinuation:
    HR: 3.63 (95% CI: 2.58, 5.10)
• The risk of relapse was not significantly influenced by:
  • The type of anxiety disorder
  • The duration of previous treatment
  • The duration of follow-up
  • The mode of discontinuation
  • Any concurrent psychotherapy

CI=confidence interval; GAD=generalized anxiety disorder; HR=hazard ratio; OCD=obsessive–compulsive disorder; OR=odds ratio