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Pharmaceutisch Weekblad

, Volume 13, Issue 4, pp 167–175 | Cite as

Continuation and maintenance therapy with antidepressive agents

Meta-analysis of research
  • Anton J. M. Loonen
  • Petronella G. M. Peer
  • Goos J. Zwanikken
Articles

Abstract

The purpose of this study was to ascertain the clinical benefits of long-term antidepressant drug treatment in patients with recurrent major depression. Bibliographic reviews of four textbooks and five review articles, literature searches using MEDLINE (1977–1987) and EXCERPTA MEDICA (1974–1987), hand-searching of the bibliographies of identified papers, and a private set were used for data identification. The most informative, definite research report was selected using explicit criteria for evaluating study design and quality, of each described, randomized, controlled, double-blind trial of long-term antidepressant agent treatment. The trials were started at a specified period after recovery from an affective episode, in patients with major depression. Of the fifty-five originally identified articles, nine were selected that specifically addressed this purpose. The basic data were extracted in the form of 2 x 2 tables comparing the number of patients with an affective relapse to those remaining well and meta-analysed. Six of the selected trials addressed continuation and three addressed maintenance therapy. In two trials of continuation and in one trial of maintenance treatment, antidepressants were significantly more active than a placebo. In none of the trials were antidepressants inferior to a placebo. Continuation therapy with antidepressants (amitriptyline and imipramine) is effective. There are insufficient data to allow any conclusions about the efficacy of maintenance therapy with antidepressants, long-term treatment with antidepressants relative to that with lithium carbonate, or long-term antidepressant treatment in patients with chronic depression.

Keywords

Antidepressive agents Clinical trials Affective disorders Meta-analysis Depression Recurrence Relapse 

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Copyright information

© Royal Dutch Association for Advancement of Pharmacy 1991

Authors and Affiliations

  • Anton J. M. Loonen
    • 1
  • Petronella G. M. Peer
    • 2
  • Goos J. Zwanikken
    • 3
  1. 1.Psychiatric Hospital Reinier van ArkelGB VughtThe Netherlands
  2. 2.Department of Statistical ConsultationCatholic University of NijmegenHB NijmegenThe Netherlands
  3. 3.Department of PsychiatryCatholic University of NijmegenThe Netherlands

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