Relapse rates with long-term antidepressant drug therapy: a meta-analysis.
BACKGROUND
Several long-term double-blind placebo controlled trials have shown prophylactic antidepressant therapy in unipolar depression. The goal of this work was to conduct a meta-analysis that would incorporate the most recent trials and evaluate their overall level of efficacy and relapse prevention over time.


METHODS
We performed a comprehensive literature search. The extracted data from selected studies were used to construct a regression model and evaluate the effect of treatment, time on medication, severity of illness, age, gender, and number of previous episodes.


RESULTS
Across 11 maintenance treatment studies, the relapse rate was significantly different at 1 year for active drug (23%) versus placebo (51%). In addition, time on medication significantly affected the relapse rate.


CONCLUSIONS
Prophylactic antidepressant drug therapy appears efficacious in preventing future relapses across a range of illness severity as well as age. More studies are needed to explore the effects of various acute antidepressant strategies and the direct influence of treatment resistance on relapse outcomes.
Williams
Nolan
N
Mood Disorders Program, Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, USA.
Simpson
Annie N
AN
Simpson
Kit
K
Nahas
Ziad
Z
D000928:Antidepressive Agents / Q000627:therapeutic use*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D003863:Depression / Q000188:drug therapy* / Q000517:prevention & control*; D004311:Double-Blind Method; D006801:Humans; D008134:Long-Term Care; D010043:Outcome and Process Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D055502:Secondary Prevention
D000928:Antidepressive Agents