People age 70 and older who continued taking the antidepressant that helped them to initially recover from their first episode of depression were 60 percent less likely to experience a new episode of depression over a two-year study period than those who stopped taking the medication, according to a study funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health. The study addresses a major question in the treatment of depression when to discontinue medication.

Published today in the March 16, 2006 New England Journal of Medicine, the study showed that long-term treatment (for at least 2 years) after a patient is symptom-free is effective in preventing future depressive episodes.

"This study demonstrates the benefits of keeping older patients on an antidepressant long after they become symptom-free," said NIMH's director Thomas R. Insel, M.D.

The clinical trial tested whether maintenance therapy long-term treatment given to patients to enable them to maintain a symptom-free or disease-free state is effective in preventing future episodes of depression in patients 70 years and older. It also tested whether antidepressant medication and psychotherapy were effective, and whether the extent of patients' medical burden had an impact on rates of recurrence.

According to Charles F. Reynolds III, M.D., and colleagues at the University of Pittsburgh, the study speaks directly to the controversy over the benefits and risks of administering long-term antidepressant treatment to elderly patients who have only one lifetime occurrence of major depression. To date, the consensus has been that older patients experiencing their first episode of depression should be treated to full remission and then have a limited period of continuation treatment for 6 to 12 months to ensure the stability of the remission and further improve recovery.

"Most geriatric psychiatrists
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Contact: NIMH Press Office
NIMHpress@nih.gov
301-443-4536
NIH/National Institute of Mental Health
15-Mar-2006

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