The long-term treatment of depression

Depression is a recurrent and chronic disorder requiring long-term treatment. Although this fact is generally well accepted, depression remains frequently underrecognized and often undertreated. Recent guidelines recommend that treatment with antidepressants should be continued for at least 4 to 6 months after the initial response and that long-term prophylactic treatment be given to patients who have experienced 2 or more depressive episodes. However, there is little consensus on the duration for which continuation or maintenance treatment should be given. This article reviews the long-term strategy for the treatment of unipolar major depression, particularly in terms of duration of treatment, and which types of patients would benefit from maintenance treatment.