title: Adequacy of continuation and maintenance treatments for major depression in Japan.
abstract: Guidelines for treating depression often recommend continuing antidepressants at least for 6 months after remission. Whether this recommendation is implemented in daily practices represents a serious concern. We aimed to examine adequacy of continuation and maintenance treatment in Japan. A naturalistic prospective follow-up study with mood disorders was undertaken in 23 psychiatric departments from all over Japan. A total of 95 patients diagnosed with major depression were followed up every month until treatment termination and every 6 months thereafter. In this study, the cohort received 45.1 (SD = 64.7) mg of imipramine or equivalent per day during continuation phase, and about 74% were prescribed inadequate doses, i.e. less than 75 mg/day. At maintenance phase immediately before relapse, average dosage was 42.0 (SD = 74.7) mg/day and 83% were prescribed inadequate doses. There is gross under-treatment of depression during continuation and maintenance phases in Japan.
authors.affiliation: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. akifujita@hcc6.bai.ne.jp
authors.forename: Akiko
authors.initials: A
authors.lastname: Fujita
authors.forename: Hideki
authors.initials: H
authors.lastname: Azuma
authors.forename: Toshinori
authors.initials: T
authors.lastname: Kitamura
authors.forename: Kiyohisa
authors.initials: K
authors.lastname: Takahashi
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
authors.forename: Toshi A
authors.initials: TA
authors.lastname: Furukawa
mesh_terms: D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage*; D001714:Bipolar Disorder / Q000188:drug therapy*; D015331:Cohort Studies; D003266:Continuity of Patient Care; D003866:Depressive Disorder / Q000188:drug therapy*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007099:Imipramine / Q000008:administration & dosage*; D007564:Japan; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000929:Antidepressive Agents, Tricyclic; D007099:Imipramine