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Long-Term Treatment of Depression

Published online by Cambridge University Press:  06 August 2018

Stuart A. Montgomery
Stuart A. Montgomery*
Affiliation:
Academic Department of Psychiatry, St Mary's Hospital Medical School, Praed Street, London W2 1NY
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Abstract

Long-term treatment of depression encompasses two separate phases: relapse and recurrence prevention. Relapse prevention aims to consolidate the response to acute treatment. Some tricyclic antidepressants (TCAs) have been shown to be effective, possibly in lower than standard acute treatment doses. The selective serotonin reuptake inhibitors (SSRIs) have been shown to be effective at the same minimum effective doses used to treat acute depression, or in a lower dose as with citalopram. Recurrence prevention aims to reduce the risk of onset of a new episode of depression in patients with recurrent depression. Imipramine has been thoroughly studied in unipolar depressed patients in full therapeutic doses for up to five years and is clearly effective. Other TCAs have not been adequately tested and may not all be equally effective. The SSRIs fluoxetine, paroxetine and sertraline have also been shown to be effective in reducing the risk of new episodes of depression.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 165 , Issue S26: Depression: Challenge for the '90s , December 1994 , pp. 31 - 36
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

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References

Angst, J. (1992) How recurrent and predictable is depressive illness? In Long-Term Treatment of Depression (eds Montgomery, S. A. & Rouillon, F.), pp. 1–14. Chichester: Wiley.Google Scholar
Coppen, A., Ghose, K., Montgomery, S. A., et al (1978) Continuation therapy with amitriptyline in depression. British Journal of Psychiatry, 133, 28–33.CrossRefGoogle ScholarPubMed
Doogan, D. P. & Caillard, V. (1992) Sertraline in the prevention of depression. British Journal of Psychiatry, 160, 217–222.Google Scholar
Frank, E., Kupfer, D. J., Perel, J. M., et al (1990) Three-year outcomes for maintenance therapies in recurrent depression. Archives of General Psychiatry, 47, 1093–1099.CrossRefGoogle ScholarPubMed
Frank, E., Kupfer, D. J., Perel, J. M., et al (1993) Comparison of full-dose versus half-dose pharmacotherapy in the maintenance treatment of recurrent depression. Journal of Affective Disorders, 27, 139–145.Google Scholar
Georgotas, A., McCue, R. E. & Cooper, T. B. (1989) A placebo-controlled comparison of nortriptyline and phenelzine in maintenance therapy of elderly depressed patients. Archives of General Psychiatry, 46, 783–786.Google Scholar
Hamilton, M. (1967) Development of rating scale for primary depressive illness. British Journal of Social and Clinical Psychology, 6, 278–296.CrossRefGoogle ScholarPubMed
Jacoby, R., Lunn, M. A., Ardern, M., et al (1993) How long should the elderly take antidepressants? A double blind placebo-controlled study of continuation/prophylaxis therapy with dothiepin. British Journal of Psychiatry, 162, 175–182.Google Scholar
Keller, M. B., Lavori, P. W., Lewis, C. E., et al (1983) Predictors of relapse in major depressive disorder. Journal of the American Medical Association, 250, 3299–3304.Google Scholar
Klerman, G. L., Dimascio, A., Weissman, M., et al (1974) Treatment of depression by drugs and psychotherapy. American Journal of Psychiatry, 131, 186–191.Google Scholar
Kupfer, D. J., Frank, E. & Perel, J. M. (1992) Five-year outcome for maintenance therapies in recurrent depression. Archives of General Psychiatry, 49, 769–773.CrossRefGoogle ScholarPubMed
Mindham, R. H. S., Howland, C. & Shepherd, M. (1973) An evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychological Medicine, 3, 5–17.Google Scholar
Montgomery, S. A. (1989) Prophylaxis in recurrent unipolar depression: a new indication for treatment studies. Journal of Psychopharmacology, 3, 47–53.Google Scholar
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.Google Scholar
Montgomery, S. A., Dufour, H., Brion, S., et al (1988) The prophylactic efficacy of fluoxetine in unipolar depression. British Journal of Psychiatry, 153 (suppl. 3), 69–76.Google Scholar
Montgomery, S. A. & Bullock, T. (1991) Do noradrenaline uptake inhibitors provoke suicide? In Current Practices and Future Developments Into the Pharmacotherapy of Mental Disorders (eds Meltzer, H. Y. & Nerozzi, D.), pp. 131–137. Amsterdam: Elsevier.Google Scholar
Montgomery, S. A., Doogan, D. P. & Burnside, R. (1991) The influence of different relapse criteria on the assessment of long-term efficacy of sertraline. International Clinical Psychopharmacology, 6 (suppl. 2), 37–46.Google Scholar
Montgomery, S. A., Rasmussen, J. G., Lyby, K., et al (1992) Dose response relationship of citalopram 20 mg, citalopram 40 mg and placebo in the treatment of moderate and severe depression. International Clinical Psychopharmacology, 6 (suppl. 5), 65–70.Google Scholar
Montgomery, S. A. & Dunbar, G. C. (1993) Paroxetine is better than placebo in relapse prevention and the prophylaxis of recurrent depression. International Clinical Psychopharmacology, 8, 189–195.Google Scholar
Montgomery, S. A., Rasmussen, J. G. & Tangh⊘j, P. (1993) A 24-weeks study of 20 mg citalopram, 40 mg citalopram and placebo in the prevention of relapse of major depression. International Clinical Psychopharmacology, 8, 181–188.CrossRefGoogle Scholar
Prien, R. F., Klett, C. J. & Caffey, E. M. Jr (1973) Lithium carbonate and imipramine in prevention of affective episodes: a comparison in recurrent affective illness. Archives of General Psychiatry, 29, 420–425.CrossRefGoogle ScholarPubMed
Prien, R. F., Kupfer, D. J., Mansky, P. A., et al (1984) Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorders: report of the NIMH Collaborative Study Group comparing lithium carbonate, imipramine and a lithium carbonate–imipramine combination. Archives of General Psychiatry, 41, 1096–1104.Google Scholar
Prien, R. F. & Kupfer, D. J. (1986) Continuation drug therapy for major depressive episodes: how long should it be maintained? American Journal of Psychiatry, 143, 18–23.Google ScholarPubMed
Rouillon, F., Phillips, R., Serrurier, D., et al (1989) Rechutes de depression unipolaire et efficacite de la maprotiline. L'Encéphale, 15, 527–534.Google Scholar
Seager, C. P. & Bird, R. L. (1962) Imipramine with electrical treatment in depression: a controlled trial. Journal of Mental Science, 108, 704–707.Google Scholar
Stein, M. K., Rickels, K. & Weise, C. C. (1980) Maintenance therapy with amitriptyline: a controlled trial. American Journal of Psychiatry, 137, 370–371.Google Scholar
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