Current situation of long-term treatment of depression

Depression is the most common mental illness and the primary cause of disability. Currently, major depression is considered a chronic disorder, with very high lifetime recurrence rates. This article reviews the published literature on long-term treatment of depression, with special emphasis on unresolved issues of long-term treatment such as prevention of relapses and recurrences and optimal duration of maintenance treatment. Current recommendations on the treatment of major depression include three phases: the acute phase (4-8 weeks), where the objective is to achieve remission; the continuation phase, to maintain remission; and the maintenance phase, to prevent possible recurrences. Most of the studies reviewed support antidepressive therapy during continuation and/or maintenance phases, in patients who have responded to acute and/or continuation treatment with antidepressants. Current scientific evidence suggests that the effect of treatment persists for at least two years of maintenance treatment with antidepressants.