Toolkit to prompt and support stopping antidepressants in general practice: an interview study exploring patient participants' experiences in the RELEASE trial.

Clinical Snapshot

Key Findings

• P Value: Not applicable - qualitative study

• Effect Size: Not applicable - qualitative study

• Primary Outcome: Seven themes identified describing patient experiences with RELEASE toolkit

• Nnt Or Sensitivity: Not applicable - qualitative study provides experiential insights rather than quantitative measures

• Confidence Interval: Not applicable - qualitative study

Clinical Application

Toolkit appears feasible but requires addressing barriers including mini-dose access and withdrawal symptom management Highly relevant - conducted in Queensland general practice, addresses PBS-subsidised antidepressant use patterns, aligns with RACGP guidelines on shared decision-making Adults on long-term antidepressants (>12 months) in Australian general practice seeking to discontinue treatment

Abstract

OBJECTIVE: To explore patient experiences with the RELEASE (Redressing long-term antidepressant use) toolkit resources, including antidepressant hyperbolic tapering plans designed to minimise withdrawal symptoms as part of the RELEASE trial's implementation evaluation to understand what aspects of the toolkit work well and identify areas where refinement could enhance future implementation. The RELEASE intervention, a multistrategy intervention codesigned with general practitioners (GPs) and patients to prompt and support stopping long-term (>12 months) antidepressants, is being evaluated in an effectiveness-implementation hybrid type-1 cluster randomised controlled trial in general practice. STUDY DESIGN: One-to-one semistructured qualitative interviews using reflexive thematic analysis to identify patterns of shared meaning. SETTING: General practice, south-east Queensland, Australia. PARTICIPANTS: Adult participants (aged 18 years or older) taking an antidepressant long-term allocated to the intervention arm of the RELEASE trial. RESULTS: 31 participants with an average duration of antidepressant use of 16.5 years (range 1-30 years) were interviewed. Seven themes were identified. Across seven themes, participants described how the RELEASE toolkit resources prompted reflection on their antidepressant use, supported informed conversations with GPs, and offered tapering plans that were both structured enough to instil confidence and flexible enough to help participants feel in control of their tapering journey. They also identified barriers, including beliefs that very small tapering doses were unnecessary, difficulty accessing the mini-doses required for hyperbolic tapering and the challenge of managing withdrawal symptoms. For those who successfully stopped, the transition was associated with a renewed sense of autonomy. Participants also offered practical suggestions to strengthen the toolkit and its broader implementation. CONCLUSIONS: The RELEASE toolkit resources played a meaningful role in prompting and supporting informed shared decision-making and guiding attempts to stop antidepressants. Clearer messaging about the potential for withdrawal symptoms and access to mini-doses for tapering are needed to support patients to safely stop antidepressants. TRIAL REGISTRATION NUMBER: ACTRN12622001379707p; Pre-results.

References

1. 1.Ferreira, P. M., McDonald, S., Wallis, K. A., & Donald, M. (2026). Toolkit to prompt and support stopping antidepressants in general practice: an interview study exploring patient participants' experiences in the RELEASE trial. BMJ Open. https://doi.org/10.1136/bmjopen-2026-116702