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Re: FINALLY GOING sweetmarie

Posted by Cam W. on June 17, 2001, at 9:10:10

In reply to Re: FINALLY GOING dove, posted by sweetmarie on June 17, 2001, at 8:38:02

Marie - When mentioned in clinical reviews, the time one should remain taking an antidepressant is 6 months. This means that one should take an antidepressant for "at least" 6 months after remission is attained. It can take 4 to 12 weeks (or longer) to enter antidepressant-induced remission.

OTOH, in clinical trials, the time when starting an antidepressant is used as the starting date. Rarely, are these studies followed through to remission and recovery, but when they are, the studies still use the time when starting the drug, as a start date.

I think this is where the confusion comes in. Really, the date of remission should be judged the start of the antidepressant working, but this date is sort of fuzzy as entering remission is gradual. Therefore, many docs use the rule of thumb that, the first date that they see their patient is recovering (4 - 12 weeks into treatment), they will try to maintain that patient for at least another six months. Most docs nowadays just keep a person on an antidepressant for at least a year from the start date, and then evaluate the person at that time; using their clinical judgement to determine whether that person should remain on an antidepressant or whether it is time to try to take the person off of the antidepressant.

I suppose that it was this sort of wishy-washy answer that the nurses gave you, isn't it? None of these rules are written in stone, and it is really up to the judgement of the doctor. Research has bourne out though, that if people stop taking an antidepressant within 6 months of remission, there is approximately a 60% to 80% chance of relapsing. These figures are for first-time treatment-responsive depressions.

This is probably not the "rule of thumb" in treatment-resistant cases like yours, where long-term therapy, after (if) remission is achieved. So, to answer your question in the context of your treatment-resistant depression: it depends on how you do eventually respond to the medication.

I hope that this mess is of some help. - Cam


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poster:Cam W. thread:55847
URL: http://www.dr-bob.org/babble/20010612/msgs/66857.html