Abstract
Evidence suggests that depression is a chronic and recurrent illness rather than a limited or acute condition. Recommendations issued by the World Health Organization Mental Health Collaborating Centres in 1989 called for the continuation of antidepressant therapy for up to 6 months. Many depressed patients require treatment for as long as 2 years or more. The potential complications of antidepressant therapy are of greater concern during long-term prophylactic treatment than during the acute management of depressive episodes. Patient noncompliance, pharmacologic side effects, drug interactions, and drug overdose are among the factors that can interfere with the course of chronic therapy. Discontinuation of antidepressant medication after long-term treatment should be slow, gradual, and individualized, regardless of the pharmacologic agent administered.
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