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Continuation and maintenance therapy in depression.

E S Paykel1

  • 1Department of Psychiatry, University of Cambridge, UK.

British Medical Bulletin
|November 27, 2001
PubMed
Summary

Longer-term antidepressant treatment, 9-12 months post-remission, prevents unipolar depression relapse. Gradual withdrawal is crucial. Cognitive therapy may augment antidepressants for residual symptoms.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Pharmacology

Background:

  • Longer-term antidepressant treatment is established for unipolar depression.
  • Continuation therapy aims to prevent early relapse.
  • Maintenance treatment addresses recurrent depression risks.

Purpose of the Study:

  • To review evidence for extended antidepressant treatment durations.
  • To evaluate the role of psychotherapy in depression recurrence prevention.
  • To assess combination therapy benefits.

Main Methods:

  • Literature review of clinical trials and evidence-based guidelines.
  • Analysis of studies on antidepressant continuation and maintenance phases.
  • Evaluation of interpersonal and cognitive therapy efficacy.

Main Results:

  • Evidence supports 9-12 months of antidepressant continuation post-remission.
  • Antidepressants are indicated for maintenance in recurrent depression.
  • Gradual withdrawal over 3+ months is recommended.
  • Cognitive therapy shows promise for relapse prevention and augmenting antidepressants.

Conclusions:

  • Extended antidepressant treatment (9-12 months) is beneficial for unipolar depression.
  • Gradual antidepressant tapering is essential to prevent withdrawal and relapse.
  • Cognitive therapy offers a valuable adjunct to pharmacotherapy, especially for residual symptoms.

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