A major depressive episode left untreated may last between 6 and 24 months in 90-95% of cases while the remaining 5-10% could last more than 2 years. Two-thirds of patients are expected to 'respond' to anti-depressant medication and in controlled studies, one-third are expected to respond to placebo. Approximately 15-20% of patients will fail to respond to any anti-depressant trial. It is estimated that approximately 50% of patients will reach remission within the first 6 months and about two-thirds within 2 years of the start of therapy.
The variables predictive of relapse include: (i) multiple prior episodes; (ii) severe episodes; (iii) long-lasting episodes; (iv) episodes with psychotic or bipolar features; and (v) incomplete recovery between two consecutive episodes.
The pharmacological treatment of major depressive episodes can be divided into three phases:
1 An acute phase, which lasts between 6 and 12 weeks, in which the goal is to achieve a complete symptom remission.
2 A continuation phase, which spans the 12th and 52nd weeks, and which aims to prevent the recurrence of a depressive episode. The anti-depressant medication must be maintained at the same dose.
3 A maintenance phase, which aims to maintain the patient in a euthymic state indefinitely. Its duration depends on the number of prior major depressive episodes. As stated above, among patients with primary depression, after a first major depressive episode, the probability of future episodes is about 50%; it increases to 70% after a second episode and is more than 90% after a third episode. The decision to keep the patient on anti-depressant drugs beyond the first 12 months and the duration of a maintenance phase should be decided after consultation with a psychiatrist.
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Learning About How To Defeat Depression Can Have Amazing Benefits For Your Life And Success! Discover ways to cope with depression and melancholic tendencies! Depression and anxiety particularly have become so prevalent that it’s exceedingly common for individuals to be taking medication for one or even both of these mood disorders.