Rodriguez-Sanchez Julia, Lewis Gemma, Solmi Francesca, Bone Jessica K, Moore Michael, Wiles Nicola, Harmer Catherine J, Duffy Larisa, Lewis Glyn
Division of Biosciences, UCL, London, UK.
Division of Psychiatry, UCL, London, UK.
Psychol Med. 2023 Oct;53(14):6592-6599. doi: 10.1017/S0033291722003981. Epub 2023 Feb 2.
Antidepressants have been proposed to act via their influence on emotional processing. We investigated the effect of discontinuing maintenance antidepressant treatment on positive and negative self-referential recall and the association between self-referential recall and risk of relapse.
The ANTLER trial was a large ( = 478) pragmatic double-blind trial investigating the clinical effectiveness of long-term antidepressant treatment for preventing relapse in primary care patients. Participants were randomised to continue their maintenance antidepressants or discontinue via a taper to placebo. We analysed memory for positive and negative personality descriptors, assessed at baseline, 12- and 52-week follow-up.
The recall task was completed by 437 participants. There was no evidence of an effect of discontinuation on self-referential recall at 12 [positive recall ratio 1.00, 95% CI (0.90-1.11), = 0.93; negative recall ratio 1.00 (0.87-1.14), = 0.87] or 52 weeks [positive recall ratio 1.03 (0.91-1.17), = 0.62; negative recall ratio 1.00 (0.86-1.15), = 0.96; ratios larger than one indicate higher recall in the discontinuation group], and no evidence of an association between recall at baseline or 12 weeks and later relapse [baseline, positive hazard ratio (HR) 1.02 (0.93-1.12), = 0.74; negative HR 1.01 (0.90-1.13), = 0.87; 12 weeks, positive HR 0.99 (0.89-1.09), = 0.81; negative HR 0.98 (0.84-1.14), = 0.78; ratios larger than one indicate a higher frequency of relapse in those with higher recall].
We found no evidence that discontinuing long-term antidepressants altered self-referential recall or that self-referential recall was associated with risk of relapse. These findings suggest that self-referential recall is not a neuropsychological marker of antidepressant action.
抗抑郁药被认为是通过影响情绪加工发挥作用。我们研究了停止维持性抗抑郁治疗对正向和负向自我参照回忆的影响，以及自我参照回忆与复发风险之间的关联。
ANTLER试验是一项大型（n = 478）实用性双盲试验，旨在研究长期抗抑郁治疗对预防初级保健患者复发的临床疗效。参与者被随机分配继续维持性抗抑郁治疗或通过逐渐减量至安慰剂来停药。我们分析了在基线、12周和52周随访时对正向和负向人格描述词的记忆情况。
437名参与者完成了回忆任务。没有证据表明在12周时停药对自我参照回忆有影响[正向回忆比率1.00，95%置信区间（0.90 - 1.11），P = 0.93；负向回忆比率1.00（0.87 - 1.14），P = 0.87]或52周时[正向回忆比率1.03（0.91 - 1.17），P = 0.62；负向回忆比率1.00（0.86 - 1.15），P = 0.96；比率大于1表明停药组回忆更高]，也没有证据表明基线或12周时的回忆与后期复发之间存在关联[基线，正向风险比（HR）1.02（0.93 - 1.12），P = 0.74；负向HR 1.01（0.90 - 1.13），P = 0.87；12周，正向HR 0.99（0.89 - 1.09），P = 0.81；负向HR 0.98（0.84 - 1.14），P = 0.78；比率大于1表明回忆较高者复发频率更高]。
我们没有发现证据表明停止长期抗抑郁治疗会改变自我参照回忆，也没有发现自我参照回忆与复发风险相关。这些发现表明自我参照回忆不是抗抑郁作用的神经心理学标志物。
