How long do we have to stay on with the depression medication?
It is
important to understand that antidepressant therapy is used for treatment
of the acute illness as well as to maintain remission of the depression.
Remission may be partial or full and can occur within 4 to 6 weeks after
the initiation of medication. Full remission has occurred when there are
no longer any symptoms. This is not, however, a good time to stop the
medication. Many people stop their antidepressant treatment prematurely
because they feel better. It may be thought that the medication is not
needed anymore or even questioned whether the medication had anything to
do at all with the improvement (particularly if there were no side
effects).
Recurrence
of Depresssion
Close
monitoring by your doctor can help to address questions of efficacy as
well as to provide the feedback as to level of improvement. When
medication is discontinued prematurely, a relapse or recurrence is likely
to occur soon thereafter. A relapse occurs if there is a return of
depression within the period of time known as remission, which is within
6 months of remission of symptoms. Recurrence occurs if depression
returns during the period of recovery, which is after 6 months of
remission. Statistically speaking, after remission of a depressive
episode, there is highest risk for recurrence within the first year. The
standard recommendation therefore is to continue antidepressant therapy
for 9 months to 1 year after complete remission of symptoms. After one
episode of depression, the risk for recurrence after a year in remission
is similar to the baseline risk for depression. The more episodes of
depression that occur over time, however, the higher is the risk for
future episodes. In fact, a history of three or more episodes places
patients at a greater than 80% risk for recurrence. Therefore, after two
or more episodes (depending on severity), your doctor may recommend
indefinite treatment with an antidepressant in order to reduce your risk
for recurrence.
