Study Design: Ransomised Control Trial
Disease Area: Mental health / Primary Care
Funder: NIHR
Sponsor: University of Southampton
Chief Investigator: Prof Tony Kendrick

Reviewing long term antidepressant use by careful monitoring in everyday practice (REDUCE)


There is considerable concern about increasing antidepressant use in England. GPs are writing more than 60 million prescriptions a year, to around 1-in-10 adults. Some people need long-term antidepressants to stop them getting depressed, but a third-to-a-half could possibly stop them without relapsing. However, stopping is not always easy. Some patients may experience withdrawal symptoms, while others may be fearful that they will experience them.   

People taking antidepressants have told us their GPs often do not review them and just give repeat prescriptions. Studies show that when GPs review patients on long-term antidepressants and advise them where appropriate to withdraw, only 1 in 14 is able to stop. Patients can be fearful and withdrawal can be tricky so GPs and Nurse Practitioners (NPs) who prescribe anti-depressants need to guide patients who want to withdraw, and patients need around the clock support. 

Research Programme Aims:

  • Identify feasible, safe, effective, and cost-effective ways of helping patients taking long-term antidepressants taper off and stop treatment, when appropriate. 
  • Check the usefulness of the programme in helping patients stop treatment through a randomised controlled trial in three centres (Southampton, Liverpool and Hull universities), and estimate financial benefits for the NHS. 
  • Assess the effectiveness of the Internet and telephone interventions, in terms of reductions in antidepressant use in the absence of worsening of depression, and assess patients’ and practitioners’ use of the interventions   
  • A qualitative process evaluation will be conducted through open-ended interviews with 15-20 patients and 15-20 practitioners in each arm.  
  • We will also look at the use of the telephone support provided by psychological practitioners (PWPs), and any technical support needed for patients to be able to use the internet intervention.   
  • Finally, we will explore why the interventions were effective or not, depending on the results. 

This research is funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Health Research (PGfAR) programme (project number RP-PG-1214-20004), and is supported by the NIHR Clinical Research Network (CRN). 

Chief Investigator

Prof Tony Kendrick GP and Professor of Primary Care - University of Southampton

HHTU Study team

Dr Mahboobeh Haji-Sadeghi - Trial Manager
Amy Porter - Trial Administrator
Prof Judith Cohen - HHTU Director


Prof Una Macleod - Dean and Professor of Primary Care Medicine - Hull York Medical School
Wendy O'Brien - Programme Manager - University of Southampton
Hannah Bowers - Study Coordinator - University of Southampton

Email Address

Participating sites and their Project Investigators

We were a site for this study and there were two further sites.

  • Hull Prof Una Macleod
  • Liverpool Prof Mark Gabbay
  • Plymouth Prof Tony Kendrick


Kendrick, T., Geraghty, A.W.A., Bowers, H. et al. REDUCE (Reviewing long-term antidepressant use by careful monitoring in everyday practice) internet and telephone support to people coming off long-term antidepressants: protocol for a randomised controlled trial. Trials 21, 419 (2020).

Conference presentations

ICAHR Seminar 2023 (University of Hull)
Sadeghi, M. H. REDUCE Antidepressant Reduction Programme (Reviewing Long Term Antidepressant Use By Careful Monitoring In Everyday Practice)

SAPC 2023
Bowers H, Woods C, Page H, Sadeghi M, Din A, Leydon G, Geraghty A, Kendrick T, Tiwari R on behalf of the REDUCE research team. What were Health Professionals’ perspectives of antidepressant discontinuation during the REDUCE trial?

Allam Lecture 2023 (University of Hull)
Sadeghi, M. H. REDUCE Antidepressant Reduction Programme (Reviewing Long Term Antidepressant Use By Careful Monitoring In Everyday Practice)

ICTMC 2022 (Harrogate)
Sadeghi, M.H., Din, A., Tiwari, R., Bowers, H., Page, H., Khan, N., Cohen, J., Macleod, U., Kendrick, A. P-192 Strategies to increase retention of participants in a definitive RCT: aiming to retain power in a study impacted by COVID-19
In Sydes, Matthew, Gillies, Katie, & Williamson, Paula. (2023). ICTMC 2022: 6th International Clinical Trials Methodology Conference -- book of abstracts. Zenodo.