When to stop?

Figures & data

Table I.  Drug therapy initiated in general practice: Textbook recommendations on duration and discontinuation of therapy.

		Recommendations
ATC codes	Drug groups	A	B	C	D	E	F	Indications
A02BA + C	H2-receptor antagonists and proton pump inhibitors	1	1	1	3			Dyspepsia
A08	Anti-obesity drugs		2	3	1			Overweight
A10A	Insulin		4	2				DM, type 1&2
A10B	Oral antidiabetics		4	2				DM type 1&2
C01A	Digoxin		5	1				Cardiac failure, arrhythmia
C01D	Nitrates		6					Coronary syndrome
C03 + 07 + 08 + 09A + C	Antihypertensives^1		5				1	Hypertension
C10AA	Statins		5			1		Hypercholesterol
C10AB	Fibrates		6					Hypercholesterol
D01A	Antimycotics (derm.)			1	5			Dermal fungal infection
D07	Glucocorticoids (derm.)		3	3				Dermatitis/eczema
G03A	Oral contraceptives	1	4	1				Contraception
G03C + D+F	Estrogen and/or progestogen		4		2			Bleeding disorder
H02A	Glucocorticoids (systemic)		1	5				Anti-inflammatory
J01	Antibiotics			1	5			Several infections
J05	Antivirals		1	2	3			Influenza, herpes simplex/zoster
M01A	NSAIDs		6					Anti-inflammatory
N02A	Opioids		4	2				Severe pain
N02C	Anti-migraine drugs		6					Migraine
N05B + C	Anxiolytics/hypnotics		1	4	1			Anxiety, sleep disturbances
N06	Antidepressants		1	1	4			Depression, acute
R03	Anti-asthma drugs		1	5				Asthma
R06	Antihistamines (systemic)		6					Allergic reactions

Notes: ¹Diuretics, betablockers, Ca antagonists, ACE inhibitors, Ang. tens. II inhibitors (five books only).

Recommendations – as given in the six reviewed books (see text): A: No text on drug/indication; B: No mention of time limitations or optimal duration of therapy; C: Mention of possible time limitations, but no mention of optimal length of therapy, or only vague suggestions; D: Specific recommendations for duration of therapy; E: Specific indication that the therapy is considered lifelong; F: Diagnostic discontinuation: Indication that therapy usually is lifelong, but that discontinuation may be recommendable to exclude false indication or recovery.

Numbers in italics indicate the number of books with the given recommendation score (A–F).