Introduction
SPD
RECURRENCE
The use of antidepressant medication (ADM) has been rising for many years. It has been estimated that prescription of ADM has doubled between 2003 and 2013 in Western countries [Systematic reviews have suggested that the most important barriers to discontinuation include fear of relapse or recurrence, actual relapse or recurrence, withdrawal symptoms, insufficient evaluation and monitoring, lack of support, and life circumstances [Discontinuation rates range between 40 and 95% when additional support is provided, and may be as low as 6% and 7% when patients only receive the advice to taper by their GP [Mindfulness-based cognitive therapy (MBCT) has been hypothesized to support the tapering process [The current study aimed to investigate the effectiveness of MBCT added to supported protocolized discontinuation (SPD) compared with SPD alone to successfully discontinue long-term ADM use in primary care. We selected patients interested in discontinuation, enhanced usual care by providing taper support materials to patients and GPs, and offered patients an MBCT intervention with tapering support explicitly embedded within the mindfulness framework. We used a cluster-randomized design to avoid contamination and to simplify research procedures for GPs and mental health nurses. We hypothesized that the MBCT group would have higher rates of succesful discontinuation. In addition, we expected that adding MBCT to SPD would produce more beneficial mental health outcomes across the 12 months follow-up period.