ANTLER 75+

• Research type

  Research Study

• Full title

  Antidepressants to prevent relapse in depression in older people (ANTLER 75+ Trial) – a double blind randomised controlled trial to evaluate the effectiveness and cost-effectiveness of continuing antidepressants

• IRAS ID

  1009793

• Contact name

  Rob Howard

• Contact email

  robert.howard@ucl.ac.uk

• Sponsor organisation

  University College London

• ISRCTN Number

  ISRCTN26190474

• Research summary

  Depression frequently affects older adults with 1 in 7 requiring treatment. General practitioners often prescribe antidepressants. However, it is unclear how long antidepressants should be continued for once symptoms have improved.
  Many individuals are eager to discontinue their antidepressants quickly. However, research involving younger participants, and limited data from older adults, indicate that maintaining antidepressants for at least six months post-recovery can help lower the chance of depression recurrence. The ANTLER clinical trial (adults aged 18-74), showed that continuing antidepressants for 12 months after recovery reduced the likelihood of depression returning by half.
  Depression in individuals aged 75 and older may respond differently to treatment compared to younger individuals. Risk factors vary, and older adults are more prone to have additional physical illnesses and conditions that may affect blood supply to the brain, which can reduce the effectiveness of antidepressants and heighten side effects.
  We will conduct a similar trial to the ANTLER study, targeting individuals aged 75 and older. Participants will have an equal chance of either continuing antidepressants for a year or reducing their dose before switching to a placebo. All medications provided during the trial will be indistinguishable to ensure that both participants and trial staff are blind to the treatment being administered. The primary focus will be to monitor a relapse of depression, if any, throughout the year-long study.
  We will also explore the symptoms of antidepressant withdrawal, effects of these medications on anxiety, memory, and concentration, as well as their side effects. Additionally, we will examine the health and social implications, impact of depression on family life, and the economic consequences of either continuing or discontinuing treatment. The findings will assist doctors in making informed decisions on how to balance the potential benefits and risk

• REC name

  South Central - Hampshire B Research Ethics Committee

• REC reference

  24/SC/0247

• Date of REC Opinion

  19 Aug 2024

• REC opinion

  Further Information Favourable Opinion