Posted by SLS on July 21, 2005, at 21:37:13
In reply to Re: Bad (but expected) news about ADs, posted by linkadge on July 21, 2005, at 20:52:05
> Unmedicated depression usually remits within a year. Rarely longer.
Where did you get this information from?
What about recurrent depression?
> Antidepressants are taken on average much longer than a year.
"much"?
How much longer?
It has been shown that the risk of relapse into depression rises if one does not continue with antidepressants for at least 6-9 months after remission is achieved, with some doctors suggesting 12-14 months for more severe cases. Upon the premature discontinuation of an antidepressant, for those who do relapse, this usually occurs withing the first 4 months.
There are many variables to be taken into consideration when deciding how long to continue treatment for.
> Antidepressnats worsen the course of the illness.
Unipolar disorder? In most cases, I would disagree with this. It is an interesting idea that should be looked at, but with chronic or recurrent depression, there is little better choice than to intervene biologically.
Bipolar disorder? Sometimes. This depends on several factors, not the least being the coadministration of a mood-stabilizer.
1: Br Med Bull. 2001;57:145-59. Related Articles, Links
Continuation and maintenance therapy in depression.Paykel ES.
Department of Psychiatry, University of Cambridge, UK.
This paper reviews longer term treatment for unipolar depression. Antidepressant continuation for prevention of early relapse has been routine for many years. Recent evidence supports a longer period of 9 months to 1 year after remission. Antidepressants are also effective in maintenance treatment for recurrent depression, and are indicated where there is clear risk of further episodes. Antidepressant withdrawal after continuation and maintenance should always be gradual, over a minimum of 3 months and longer after longer maintenance periods, to avoid withdrawal symptoms or rebound relapse. Trials of interpersonal therapy in the prevention of recurrence show some benefit, but effects are weaker than those of drug and additional benefit in combination is limited. There is better evidence for effects of cognitive therapy in preventing relapse and an emerging indication for its addition to antidepressants, particularly where residual symptoms are present.
Publication Types:
Meta-AnalysisPMID: 11719914 [PubMed - indexed for MEDLINE]
- Scott
poster:SLS
thread:530123
URL: http://www.dr-bob.org/babble/20050718/msgs/531206.html