Longerterm treatment Continuation treatment

In recent years, it has become apparent from follow-up studies that the long-term outcome of depression is still often problematic. It is customary to distinguish between relapse, or early symptom return, assumed to be a return of the original episode, and later recurrence of a new episode. (49 In parallel, drug treatment after the acute episode has been divided into earlier continuation treatment, to prevent relapse, and longer-term maintenance treatment to prevent recurrence.

There have been many controlled trials of continuation treatment, in which responders to acute treatment are randomized either to withdraw double blind on to placebo or to continue on active drug for 6 to 8 months. All studies show substantial benefit from continuation. (41) A recent controlled trial of fluoxetine with staged withdrawal showed benefit of continuation for 24 and 38 weeks, but not 62 weeks. (42>

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