title: Relapse rates with long-term antidepressant drug therapy: a meta-analysis.
abstract: 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.
authors.affiliation: Mood Disorders Program, Department of Psychiatry, Medical University of South Carolina, Charleston, South Carolina, USA.
authors.forename: Nolan
authors.initials: N
authors.lastname: Williams
authors.forename: Annie N
authors.initials: AN
authors.lastname: Simpson
authors.forename: Kit
authors.initials: K
authors.lastname: Simpson
authors.forename: Ziad
authors.initials: Z
authors.lastname: Nahas
mesh_terms: 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
chemical_list: D000928:Antidepressive Agents