Duration of therapy for depression
Drug therapy plays an important role in the treatment of depression. It is the treatment of choice for moderate and severe depression, but a combination with accompanying psychological care is recommended. How long drug therapy is necessary depends, among other things, on whether it is the first depressive episode or whether depressive episodes have already recurred several times.
In general, the drug therapy of depression is divided into a phase of acute therapy, a phase of maintenance therapy and a phase of recurrence prophylaxis. The acute therapy usually lasts 6-12 weeks. In the subsequent maintenance phase, the drug that was also effectively used in the acute phase is continued to be administered in the same dosage.
Drug therapy in the maintenance phase should be continued for 6-9 months, sometimes even 12 months. Afterwards, in most cases, an attempt is made to slowly balance the drug. This means that the dose is slowly reduced until the drug can be discontinued completely.
If depressive symptoms reappear during this phase, consideration should be given to continuing the drug therapy of the maintenance phase for another month. In patients who have already suffered several relapses, i.e. in whom the depression has reappeared after some time after the symptoms have disappeared, relapse prophylaxis can be useful, which follows the maintenance phase. It should prevent the symptoms from recurring after some time.
The duration of the phase of recurrence prophylaxis depends very much on the patient’s medical history; it usually lasts at least one year, but may be necessary for several years or even for life.During this time, the medication that was effective in the acute and maintenance phases should continue to be given. Depending on whether it is the first occurrence of a depression or whether it has already recurred several times, the duration of therapy for a depression thus ranges from a minimum of 7-8 months to a lifelong therapy. An untreated single-phase depression can last for more than half a year.
If therapy is started, the prospects are much better. Depressive phases last on average 3-4 months and show a lower relapse rate. The therapy usually extends beyond the duration of the depression.
This reduces the risk of falling ill again. Only 25% of patients are cured after a single treatment, the rest have to fight their depression again. In the course of their lives, people suffering from depression have to endure an average of 4 intervals of worsening, depression and build-up of their mood.
The risk to experience a depressive phase again is 70%. Thus, once a depression has become pronounced, it can last for years, in severe cases for decades. If the depression progresses in intervals, the mood-stable episodes vary in length. However, they generally become shorter with each depressive phase and often no longer reach the mood level the patient is used to. The duration of depressive phases and the risk of chronification increase with age.
