Background The purpose of this study was to examine the effect of trea
tment on the long-term course of geriatric depression. Method Eighty-f
our elderly patients who had responded to treatment of the index episo
de of major depression were maintained on Full-dose antidepressant med
ication and followed on a monthly basis for two years. Relapse and rec
urrence were treated in a systematic manner. Results The cumulative pr
obability of surviving for two years without relapse or recurrence was
74%. Of the 14 patients who suffered recurrence following recovery fr
om the index episode, all responded to a change of treatment, and 71%
remained well for the remainder of the study. The risk of recurrence w
as significantly increased by a delayed response to treatment of the i
ndex episode. Conclusions Continuation and maintenance treatment with
hull-dose antidepressant medication, frequent follow-up, and vigorous
treatment of relapses and recurrences, were associated with a good out
come in this group of elderly patients.