[Long-term administration of antidepressive agents: maintenance therapy and phase prevention]

Long-term regimen of psychotropic drugs in depression is particularly indicated in those patients who benefit most from the drugs, namely patients of the "endogenous" or "endogenomorphic" type. Medication over months or even years is indicated for two frequently concurrent reasons: firstly for "maintenance therapy", i.e., medication should be continued after remission of the depressive syndrome because of not yet identifiable "vulnerability" to relapse in many patients and, secondly, for "prophylactic therapy", i.e. medication can be given during apparent psychological health and in the absence of any imminent risk in order to prevent a possible new episode of depression. Long-term regimen of both types of medication is different, though not decisively so. Neither can cure a patient of depression; however, recurrence of the psychopathological syndrome can be successfully prevented. This paper presents a practical and updated discussion of various questions related to long-term regimen with psychotropic drugs used in depression: tricyclic antidepressants, lithium, carbamazepine and others.