Antidepressant Maintenance Reduced Depressive Recurrence

An US 2^nd phase randomized clinical trial revealed that maintenance of antidepressant medication treatment was associated with a reduced risk of depressive recurrence, but previous treatment with cognitive behavioral therapy (CBT) was not. The study included a total of 292 adult outpatients (171 women; mean age, 45.1 years) with chronic or recurrent major depressive disorder (MDD) and had recovered from a chronic or recurrent major depressive episode with antidepressant medication treatment alone or in combination with CBT in the 1^st phase. Patients in the 2^nd phase were randomized to receive maintenance or withdrawal of treatment with antidepressant medications and were followed for 3 years between 2003 and 2012. Antidepressant medication maintenance was associated with lower rates of recurrence compared with medication withdrawal regardless of whether patients had achieved recovery with monotherapy treatment in the 1^st phase (48.5% with medication maintained vs 74.8% with medication withdrawn) or combination therapy treatment (48.5% with medication maintained vs 76.7% with medication withdrawn). Maintenance vs withdrawal of medication was associated with sustained recovery rates (odds ratio [OR], 2.54). The interaction of the 1^st phase and the 2^nd phase treatment conditions did not have a significant association with sustained recovery (OR, 1.14). However, prior studies have shown benefit when CBT was added to pharmacologic agents, and when CBT was provided in the absence of antidepressant treatment, a preventive effect on depressive relapse was noted. Source: https://jamanetwork.com/