Welcome to Medscape's new series on deprescribing. In this case-based series, I will present a common clinical scenario drawn from my own practice, and hopefully familiar to virtually all of our readers. I will tell you what I plan to do, but I am more interested in crowdsourcing a response from all of you to collectively determine best practice.
Please answer the polling question and contribute to the comments section with your own thoughts, particularly when you disagree with me.
Next month's article will follow up on this case and provide readers with a summary of responses.
You are seeing a 66-year-old woman for a routine follow-up visit. She has been a patient in your practice for the past 6 years. Her medical history is significant for osteoarthritis of the knee, depression, and overweight. She tells you that since her last visit 4 months ago, she has been feeling well. Her knee is doing better overall with regular acetaminophen and an exercise program. She has no other complaints.
Her only other medication is sertraline 50 mg daily, which she began for a first episode of depression 5 years ago. You perform an inventory of symptoms related to depression, asking questions about depressed mood, alterations in sleep and appetite, energy level, and interest in doing things. She has no complaints in any of these domains, and she credits the sertraline, saying, "We tried to stop it 3 years ago, and I was a wreck. I felt sick and sad. I think that I want to continue the medicine."
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Cite this: Cases in Deprescribing: When to Stop the SSRI - Medscape - Mar 26, 2019.