A qualitative study of patient views on discontinuing long-term selective serotonin reuptake inhibitors

Background. There is concern that patients may be remaining on selective serotonin reuptake inhibitors (SSRIs) longer than is clinically indicated. Previous research has explored patients' experiences of taking SSRIs and decisions about starting medication. There has been less research into patients' reasons for long-term use and their views and experiences of discontinuation. Aim. To explore patient experiences of and beliefs about their long-standing SSRI use and understand the barriers and facilitators to discontinuation. Design. Face-to-face semi-structured qualitative interview study. Setting. One group general practice in Southampton, UK. Findings. Three overarching themes were identified: (i) patient uncertainty about the benefits of, and continued need for, SSRI medication; (ii) barriers to stopping, including fear of withdrawal symptoms and fear of relapse; and (iii) the importance of the GP's role in facilitating cessation. Uncertainty and fear about withdrawal symptoms and what patients would be like without their medication were key barriers to stopping, even among patients who felt no discernible benefit from taking SSRIs. Patients indicated a need to share the decision to stop with their GP. However, the majority of patients interviewed had received repeat prescriptions of SSRIs without being reviewed by the GP. Conclusions. Patients prescribed SSRI medication need to be reassured that, as with starting medication, thinking about or actually stopping medication is a task that will not be managed in isolation, but with the support of their GP.