title: Duration of initial antidepressant treatment and subsequent relapse of major depression.
abstract: BACKGROUND
  The efficacy, limitations, and methods of studying antidepressant treatment continued beyond initial weeks of acute major depression remain incompletely resolved.
  
  
  OBJECTIVE
  For subjects treated in controlled trials for acute depression, we analyzed the relationship of relapse risk within 12 months of rerandomizing to placebo versus duration of initial treatment and putative stabilization.
  
  
  METHODS
  With data from placebo arms of 45 relevant controlled trials identified in recent, systematic reviews were pooled and analyzed by regression modeling.
  
  
  RESULTS
  There was a strong inverse correlation of shorter initial treatment and greater relapse risk after rerandomizing to placebo treatment, best fit to a power function (P ≤ 0.003); relapse risk differed by 11.4-fold, declining sharply as initial treatment continued for 16 to 20 weeks or more.
  
  
  CONCLUSIONS
  Discontinuation of antidepressant treatment for major depressive episodes at times less than 6 months was associated with rising risks after randomization to continuation with placebo. This relationship requires critical consideration in both clinical management of depressed patients and the design and interpretation of treatment discontinuation trials.
authors.affiliation: From the *Department of Psychiatry, Harvard Medical School, Boston; †International Consortium for Psychotic and Mood Disorders Research, McLean Hospital, Belmont, MA; ‡Yong Loo Lin School of Medicine, National University of Singapore; Departments of §Research, and ∥General Psychiatry, Institute of Mental Health, Singapore.
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
authors.forename: Wai Keat
authors.initials: WK
authors.lastname: Lau
authors.forename: Jordan
authors.initials: J
authors.lastname: Sim
authors.forename: Min Yi
authors.initials: MY
authors.lastname: Sum
authors.forename: Kang
authors.initials: K
authors.lastname: Sim
mesh_terms: D000928:Antidepressive Agents / Q000008:administration & dosage*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000639:trends; D012008:Recurrence; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents