Remission / Continuation Phase Treatment

Wonderful — Your patient is in remission.

Here are some recommendations regarding Continuation Phase Treatment:

  • Patient who receive pharmacotherapy during acute phase treatment should continue their treatment for AT LEAST 6 to 9 months after symptom remission, at the same dose that led to a therapeutic response
  • Patients with a first episode of MDD who enter remission should be followed every 3 months for the first year and at the end of 6-9 months should be evaluated for slow tapering and discontinuation of antidepressant medication
  • For those patients with two episodes of major depression consider maintaining antidepressant medication for two years. May also consider indefinite treatment depending upon the clinical situation
  • For those patients who have had 3 or more major depressive episodes consider maintaining antidepressant medication indefinitely
  • Other groups considered at high risk for depression should also be considered for maintenance treatment including those whose depression was:
      • Prolonged
      • Associated with significant functional impairment
      • Associated with significant suicidal ideation
      • Associated with psychotic symptoms
  • For patients who were augmented with antipsychotics, consider gradually tapering and discontinuing the antipsychotics after 6-9 months.