Preventing Recurrent Depression: Long-Term Treatment for Major Depressive Disorder
Pierre Blier, MD, PhD; Martin B. Keller, MD; Mark H. Pollack, MD; Michael E. Thase, MD; John M. Zajecka, MD; and David L. Dunner, MD, Chair
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In contrast to continuation therapy, a treatment aimed at suppressing symptoms
during a current depressive episode, maintenance therapy is designed to prevent
the development of a new episode. Candidates for maintenance therapy include
patients who have achieved remission and have had 2 or more lifetime episodes,
especially if they have comorbid disorders, ongoing psychosocial stressors,
poor symptom control, or severe depressive episodes. Maintenance
pharmacotherapy data strongly support the use of antidepressants at the dosage
that helped the patient achieve remission. Other maintenance treatment
interventions include psychotherapy, especially cognitive-behavioral therapy,
and in some extreme cases, electroconvulsive therapy. Maintenance therapy
considerations for clinicians include assessing treatment guidelines,
addressing nonadherent patients, and measuring medication treatment response.
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J Clin Psychiatry 2007;68(3):e06
© Copyright 2007 Physicians Postgraduate Press, Inc.