As noted, physicians are encouraged to push treatment until symptoms remit, maximum doses are achieved, or side effects become intolerable. Once symptoms remit, medications should continue for 6 to 9 months because risk of relapse is greater if patients discontinue medications prematurely (AHCPR, 1999; Geddes et al., 2003). Patients who have had multiple episodes of depression should continue pharma-cotherapy because lifetime relapse rates for such patients are 50% to 85% (Eaton et al., 2008), and risk of recurrence increases by 16% with each successive episode (Solomon et al., 2000). Ongoing treatment should also be considered for patients who experienced severe functional impairment, severe suicidal ideation, or serious suicide attempts.
Was this article helpful?