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Clinical importance of long-term antidepressant treatment

Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch at Galveston, 1.302 Rebecca Sealy, 301 University Blvd, Galveston, TX 77555-0188, USA. Tel: +1 409 747 9791; fax: +1 409 747 8300

Correspondence: e-mail: rohirsch{at}utmb.edu

Declaration of interest R.M.A.H. received an honorarium and travel expenses from Eli Lilly & Co.

Background Depression, which only a few decades ago was considered to be a short-term illness requiring short-term treatment, is now recognised as a recurrent, sometimes chronic, long-term illness.

Aims To highlight the clinical importance of long-term antidepressant therapy in the treatment of depression.

Method The current literature was reviewed to examine the relationship between duration of antidepressant therapy and efficacy.

Results Approximately one-third to a half of patients successfully stabilised in acute-phase treatment will relapse if medication is not sustained throughout the continuation period. Only 10-15% will relapse if medication is continued. For maintenance-phase therapy, approximately 60% of patients at risk will experience a recurrent episode of depression within 1 year if untreated, whereas those who continue in treatment will have a recurrence rate of between 10% and 30%.

Conclusions Risk of relapse and recurrence of depression can be significantly reduced if adequate continuation and maintenance therapy durations are achieved.