Continuation and maintenance therapy with antidepressive agents. An overview of research

The literature was reviewed in order to ascertain the clinical benefits of long-term antidepressant drug treatment in recurrent major depression. Articles describing randomized, controlled, double-blind trials of long-term antidepressant drug treatment, starting at a specified period after recovery from an affective episode, in patients with major depression, were identified and reviewed. The authors describe, evaluate and comment on the design and quality of over 25 identified studies, 18 studies of continuation therapy and 7 of maintenance treatment. The methodological problems which are encountered in this type of research and the sources of bias which invalidate study results, are dealt with systematically. On the basis of this survey, some treatment guidelines and suggestions for future research are given.