LONG-TERM ANTIDEPRESSANTS USING

Distinction between relapse and recurrence is a major difficulty in st udies assessing the efficacy of long term antidepressant treatment. A four to sir months symptom-free period is required to talk of recovery from depression and plan a preventive treatment i.e. prevention of re currence. Compounds are not selected according to their biochemical pr ofile; the most recent antidepressant drugs were studied in that indic ation through long term controlled trials. In unipolar patients, recen t studies favour the prescription of high doses of-antidepressant drug s during at least five years. In bipolar patients, combination of long term antidepressant to lithium treatment may be of benefit to patient s whose index episode was of depressive type, but appears useless in o ther cases. In all cases, joint psychotherapy and the quality of the r elationship between the patient and the prescribing physician influenc e compliance and outcome. Dysthymia, panic disorder and obsessive-comp ulsive disorder constitute other acknowledged cases for long term pres cription of antidepressants. These indications remain empirical till c ontrolled trials have not specifically assessed each antidepressant co upound.