LONG-TERM MANAGEMENT OF DEPRESSIVE-DISORDERS

Evidence suggests that depression is a chronic and recurrent illness r ather than a limited or acute condition. Recommendations issued by the World Health Organization Mental Health Collaborating Centres in 1989 called for the continuation of antidepressant therapy for up to 6 mon ths. Many depressed patients require treatment for as long as 2 years or more. The potential complications of antidepressant therapy are of greater concern during long-term prophylactic treatment than during th e acute management of depressive episodes. Patient noncompliance, phar macologic side effects, drug interactions, and drug overdose are among the factors that can interfere with the course of chronic therapy. Di scontinuation of antidepressant medication after long-term treatment s hould be slow, gradual, and individualized, regardless of the pharmaco logic agent administered.