Unipolar depression is mostly recurrent disorder, frequency of depressive episodes increases with subsequent episodes, duration of fourth episode is half of the second episode. There are several reasons for long-term treatment of depression. To avoid recurrence, to decrease severity of subsequent episode, to avoid resistance, to decrease possibility of suicide, to maintain functional and social functioning of patients with depression.

We prospectively examined patients with diagnosis of recurrent depression in naturalistic settings. Patients we treated according the severity of the disorder and according to previous number of episodes.

Two groups of patients were compared, those treated for MDD in 2000 and those treated for MDD in 2006.

Total number of patients was (2000 n =85 2006 n = 100). We did not find any significant difference between patient who have been on monotherapy vs combinations according to age, gender, psychiatric comorbidity. The only sifnificant difference (p<0.01) was in the duration of MDD. The longer duration of the disorder had been a predisposing factor for the significantly higher combinations in the treatment of MDD.Monotherapy is preferentially used in patients with shorter duration of the disorder.