@article{01JT0YXJVJVRFEY31EY91S95ZS,
  abstract     = {{Background: Long-term use of antidepressant drugs is widespread despite guidelines
recommending limited duration. General practitioners (GPs) play a central role in reviewing
and discontinuing antidepressants, although they hesitate to initiate a discussion about the
long-term use. The potential role of pharmacists in this process is underexplored, despite
their pharmaceutical expertise and accessibility.
Objectives: To explore community pharmacists’ perspectives on the discontinuation of longterm use of antidepressants, and the barriers and facilitators to their involvement in this
process.
Design: Qualitative study.
Methods: Semi-structured interviews were conducted with 14 Belgian community pharmacists
until data saturation. Interviews were recorded, transcribed, and thematically analyzed.
Results: Four themes emerged. (1) “Antidepressants at the pharmacy: a persistent taboo”
showed pharmacists’ hesitancy to initiate discontinuation discussions due to societal
stigma and fear of being perceived as nosy. (2) “Balancing risks vs benefits” highlights that
pharmacists were primarily concerned about relapse in stable patients but recognized that a
patient request from a patient experiencing side effects may facilitate discontinuation. (3) “Is
this my role?,” pharmacists viewed GPs as the primary decision-makers in discontinuation,
limiting their role to supporting GP treatment decisions. Key facilitators for discontinuation
included a GP’s decision to stop and a motivated patient. Regular reviews by the pharmacist
could also facilitate the discontinuation process. (4) Optimizing pharmacists’ role’ with a
strong need for GP collaboration, and acknowledging a need to optimize knowledge and skills
to support antidepressant discontinuation.
Conclusion: Our study reveals that pharmacists viewed GPs as pivotal in the discontinuation
process, as they make the decisions, while they see their role as supportive, following
the doctor’s decision. However, they faced significant barriers to discontinuing long-term
antidepressants, including fear of relapse, societal taboo, and unclear responsibilities. More
education, confidence building, and better collaboration with GPs could empower pharmacists
to play a proactive role, improving the antidepressant discontinuation process.}},
  articleno    = {{20451253251333977}},
  author       = {{Van Leeuwen, Ellen and Mehuys, Els and Johnson, Chris F. and De Keyzer, An-Sofie and Boussery, Koen and Christiaens, Thierry}},
  issn         = {{2045-1253}},
  journal      = {{THERAPEUTIC ADVANCES IN PSYCHOPHARMACOLOGY}},
  keywords     = {{antidepressants,depressive disorder,discontinuation,pharmacists,primary care,COMMUNITY PHARMACISTS,PATIENT PERSPECTIVES,HEALTH-CARE,FACILITATORS,BARRIERS,DRUGS,RISK}},
  language     = {{eng}},
  pages        = {{14}},
  title        = {{The missing link? Pharmacists’ perspectives on discontinuation of long-term antidepressants : a qualitative study}},
  url          = {{http://doi.org/10.1177/20451253251333977}},
  volume       = {{15}},
  year         = {{2025}},
}

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