Relapse prevention with antidepressants

Abstract

Depression is a long term illness that is for the most part recurrent. Placebo controlled studies have shown that if antidepressant treatment of an acute episode is discontinued early relapse of the inadequately treated episode is likely. A continuation treatment period of at least 4 months is needed to consolidate response. A recent study of citalopram which found that citalopram 20 mg was as effective in relapse prevention as citalopram 40 mg in spite of being less effective in acute treatment has demonstrated the value of long term treatment studies in assessing antidepressant efficacy. Placebo controlled prophylactic studies have demonstrated the efficacy of some but not all antidepressants in preventing new episodes of depression. The SSRIs as a class appear to be effective in this aspect of treatment. The need for placebo controlled studies of the efficacy of antidepressants in long term treatment before new antidepressants are licensed is accepted by all the regulatory authorities in the EC and the USA.

Key Words:

• Citalopram
• Depression
• Long term treatment