There is increased recognition and acceptance that the majority of depressive disorders can be viewed as chronic or recurrent medical illnesses, which lead to persistent human suffering, severe psychosocial disability, and increased mortality, thus presenting highly expensive conditions in primary care. Results of controlled clinical trials indicate that patients should receive 4-6 months of continuation therapy after remission of the acute phase of the illness. Patients at risk for recurrent episodes, however, should receive a maintenance pharmacotherapy since depressive disorder appears to become more severe and potentially refractory with each new episode. This review summarizes recent research and provides guidelines for long-term treatment of depressive disorders.
Department of General Psychiatry, University Hospital for Psychiatry, Vienna, Austria
Correspondence to Siegfried Kasper MD, Professor and Chairman, Department of General Psychiatry, University Hospital for Psychiatry, Währinger Gürtel 18-20, A-1090 Vienna, Austria. Tel: +43 1 40400 3568; fax: +43 1 40400 3099; e-mail: firstname.lastname@example.org
Abbreviations 5-HT: 5-hydroxytryptamine (serotonin) ECT: electroconvulsive therapy SSRI: selective serotonin reuptake inhibitor TCA: tricyclic antidepressant