Posted by AMenz on June 14, 2001, at 10:24:29
In reply to How long on meds?, posted by SalArmy4me on June 13, 2001, at 22:55:05
Although I only have a sample of one, myself, I question the merits of maintenance therapy, specially because it lumps together BPI, BPII's and unipolars. I had a long remission period during which I was symptomatic but functional, fifteen years and unmedicated. In retrospect and after seeing that withdrawal from lithium causes severe anxiety (in my case) I think avoidance of episodes, which may come anyway, by medication which can have devastating side effects should not be automatic.
> Pharmacologic treatment should last for a minimum of 6 months after an initial episode of depression or bipolar disorder. Most clinicians will continue treatment for at least 1 year for patients with a second episode. If the patient has responded, and symptoms are resolved, the decision can be made whether to taper the patient off of the drug or continue maintenance therapy. In a National Institute of Mental Health Collaborative Depression Study, one third of patients became ill again 1 year after recovery from an index episode of depression; almost one half became ill again by 2 years; and almost three quarters by 8 years. Maintenance therapy may be continued indefinitely for patients with a history of frequent or multiple episodes of depression, major depression with preexisting dysthymia (double depression), onset of depression after the age of 60 years, long duration of individual episodes, severe index episode, poor symptom control during continuation therapy, and comorbid anxiety disorder or substance abuse. A strong family history of affective disorder also increases the risk of recurrence. Maintenance therapy with full doses of antidepressants is highly correlated with preventing recurrences for up to 5 years.
poster:AMenz
thread:66392
URL: http://www.dr-bob.org/babble/20010612/msgs/66444.html