Long-term management of chronic depression

Untreated major depression tends to either wax and wane, with repeated acut e episodes, or persist in a chronic unremitting state, which occurs in up t o 35% of depressed patients. After acute remission, those with treated chro nic major depression are at high risk of depressive relapse and recurrence. Strategies to reduce the risk of relapse and recurrence include achieving full acute remission, continuing antidepressant treatment with optimal pati ent adherence, and adding modified cognitive-behavioral psychotherapy. This article will review data relevant to the long-term management of chronic m ajor depression.