Relapse of depressed patients after effective continuation therapy

Forty-one elderly depressed patients who had responded to either nortriptyline or phenelzine were given continuation treatment for approximately 4 months (mean = 16.5 weeks) after which 19 were switched under double-blind conditions to placebo. At the end of 8 weeks, three (15.8%) of the placebo patients had relapsed and three (13.6%) of the patients kept on antidepressants had relapsed. Patients who had more prior episodes of depression had a greater risk of relapsing. The implications of these findings for continuation pharmacologic treatment in the elderly depressed are discussed.