Treatment recommendations versus treatment realities: recognizing the rift and understanding the consequences

Depression is a treatable disorder, although it often requires long-term therapy. To aid physicians in the effective long-term management of depression, treatment guidelines have been established by a number of organizations with minimum treatment duration recommendations. Unfortunately, numerous studies document a significant disparity between these recommendations and clinical practice realities. In particular, studies have shown that fewer than half of treated patients receive the recommended duration of 6 months of continuation therapy. Other clinical practice studies have reported that early discontinuation from therapy is associated with a substantial increase in the risk of relapse or recurrence. Long-term treatment of depression in clinical practice settings may benefit from a closer approximation to the conditions found in clinical trial settings.