CONTINUATION AND MAINTENANCE THERAPY OF R ECURRENT AFFECTIVE-DISORDERS

The results of recent clinical studies highlight the importance of pro phylactic treatment of affective disorders. The risk of relapse is par ticularly increased during four to six months following the remission from an acute depressive episode. in this time period continuation the rapy with the full dose of the antidepressant should be applied. After two or more depressive episodes within five years maintenance therapy with lithium or an antidepressant should be instituted. Also psychoth erapy, particularly interpersonal psychotherapy (IPT), has been shown to prevent relapses and recurrences of less severe depressive disorder s. Due to the particularly high risk of recurrences in bipolar disorde rs prophylactic maintenance therapy should already be considered after one manic episode. Lithium and, alternatively especially in cases of schizoaffective disorder, atypic or mixed manic symptoms, carbamazepin e or valproate are effective as preventive treatment. In this article the clinical studies that form the basis of these guidelines will be d iscussed.