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Current Perspectives in the Treatment of Depression

Prevention of Relapse and Recurrence in Depression: The Role of Long-Term Pharmacotherapy and Psychotherapy

Andrew A. Nierenberg, MD; Timothy J. Petersen, PhD; and Jonathan E. Alpert, MD

Published: October 1, 2003

Article Abstract

Major depressive disorder is a chronic disorder, frequently characterized by relapses and recurrences.One of the major risk factors for additional episodes of depression is the presence of residualsymptoms that persist after a depressive episode ends; these residual symptoms tend to progress toanother depressive episode. Although relapse or recurrence may be prevented with long-term pharmacotherapy,this approach is recommended only for patients at high risk of relapse or recurrence. Patientsnot at high risk who are effectively treated to full remission have a substantially lower risk ofdeveloping another depressive episode. In addition, psychotherapy, alone or combined with medication,has been shown to be effective in preventing further episodes of depression.

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