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Maintenance pharmacotherapy of unipolar depression

  • Som Forshall (a1) and David J. Nutt (a1)
Abstract
Aims and methods

The purpose of this paper is to review current evidence and opinion with regard to the long-term treatment of unipolar depression. The method employed was a Psychlit search using the search items long-term, maintenance, treatment and depression.

Results

The search yielded 91 articles.

Clinical implications

Unipolar depression is frequently recurrent and sometimes a chronic illness. The paper identifies those at greatest risk of recurrence. It goes on to examine strategies to prevent relapse and for prophylactic treatment. It concludes that continuation treatment should be sustained at full dose for 4–6 months after full remission of symptoms. Where depression is highly recurrent the acute phase dose should be maintained in the long-term.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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References
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Angst, J. (1992) How recurrent and predictable is depressive illness? In Long-term Treatment of Depression (eds Montgomery, S. & Rouillon, F.). New York: John Wiley.
Frank, E., Kupfer, D., Pere, J., et al (1990) Three-year outcomes for maintenance therapies in recurrent depression. Archives of General Psychiatry, 47, 1093 1099.
Frank, E., Kupfer, D., Pere, J., et al (1993) Comparison of full-dose versus half-dose pharmacotherapy in the maintenance treatment of recurrent depression. Journal of Affective Disorder, 27, 139 145.
GEORGotis, A., McCue, R. E. & Cooper, T. B. (1989) A placebo-controlled comparison of nortriptyline and phenelzine in maintenance therapy of elderly depressed patients. Archives of General Psychiatry, 46, 783 786.
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Johnstone, W. C., Owens, D. G. C., Lambert, M. T., et al (1990) Combination tricyclic antidepressant and lithium maintenance medication in unipolar and bipolar depressed patients. Journal of Affective Disorder, 20, 225 233.
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Sackeim, H., Prudic, J., Devanand, D. P., et al (1990) The impact of medication resistance and continuation pharmacotherapy on relapse following responses to electroconvulsive therapy in major depression. Journal of Clinical Psychopharmacology, 10, 96 104.
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World Health Organization Mental Health Collaborating Centres (1989) Pharmacotherapy of depressive disorders: a consensus statement. Journal of Affective Disorders, 17, 197 198.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Maintenance pharmacotherapy of unipolar depression

  • Som Forshall (a1) and David J. Nutt (a1)
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