Treating Depression to Remission

Over the last several years, the recommended end point in the treatment of depression has becomeremission. Patients who achieve remission not only enjoy the benefits of decreased disability and improvedfunctioning in work, family, and social situations, they also have a lower risk of disease progressionand relapse. Despite the benefits associated with remission, many patients are left with residualsymptoms that prevent them from achieving these benefits. Potential obstacles to reachingremission include diagnostic issues, inadequate treatment, lack of adherence to the treatment regimen,satisfaction with partial improvement, and failure to recognize residual symptoms. Strategies fortreating to remission include ensuring appropriate diagnosis, setting treatment goals, selecting antidepressantsthat are more likely to result in remission, providing patient education and adequate treatment,assessing for residual symptoms, and heeding partial response or lack of response by switchingor augmenting treatment.