Long-term management of depression: final recommendations

Abstract

Affective disorders are conditions with a high rate of relapse and recurrence. There are specific predictors of recurrence. Clinical trials with 24 month at least as duration with prevention of relapses and recurrence are scare (11 with a total sample of 967 randomized patients in the maintenance phase). Amitriptiline, imipramine, fenelzine and venlafaxine extended release can be considered as a first line treatment according the data from those clinical trials. Some psychotherapies has also positive results with important methodological problems in the design of the studies. Suicide, drug abuse including alcohol and comorbidity with medical disorders are the more severe and frequent long-term complications. A mood stabiliser drugs is necessary in bipolar depression. Elderly people are a population group characterized for the severity and recurrence of depressive episodes.