Five-year comparison of antidepressant monotherapy

Objective. This study compares the effectiveness of several antidepressants in maintaining remission in unipolar depressed outpatients. Method. A retrospective chart review was performed on 2475 patients being seen in a rural private psychiatric practice. The study focused on those patients who had a clinical diagnosis of unipolar depression, and who achieved remission on antidepressant monotherapy. Data collected included patient demographics, Carroll Depression Rating Scale scores, and medication history. Results. A total of 346 patients (14%) met the inclusion criteria. Patients achieved remission in an average of 0.36 years and had an average of 0.28 relapses per year of treatment. Patients on escitalopram and sertraline had the shortest time until remission (0.24 and 0.27 years, respectively) but sertraline patients remained the longest in remission (62% after 5 years) and had the lowest percentage of treatment time spent in relapse (8%). Conclusions. Sertraline and to a lesser extent paroxetine were deemed superior to several other antidepressants in terms of maintaining remission and preventing relapse.