Clinical importance of long-term antidepressant treatment

BACKGROUND: Depression, which only a few decades ago was considered to be a short-term illness requiring short-term treatment, is now recognised as a recurrent, sometimes chronic, long-term illness. AIMS: To highlight the clinical importance of long-term antidepressant therapy in the treatment of depression. METHOD: The current literature was reviewed to examine the relationship between duration of antidepressant therapy and efficacy. RESULTS: Approximately one-third to a half of patients successfully stabilised in acute-phase treatment will relapse if medication is not sustained throughout the continuation period. Only 10-15% will relapse if medication is continued. For maintenance-phase therapy, approximately 60% of patients at risk will experience a recurrent episode of depression within 1 year if untreated, whereas those who continue in treatment will have a recurrence rate of between 10% and 30%. CONCLUSIONS: Risk of relapse and recurrence of depression can be significantly reduced if adequate continuation and maintenance therapy durations are achieved.