Continuation-Phase Procedures

Antidepressant and Antimanic Medications: Continuation-Phase Procedures

Once a patient has achieved a full response, the continuation phase begins and lasts for 4-6 months. Patients are usually seen every 4-6 weeks during this phase. The primary tasks of this phase are to monitor response and to assess side effects, and the primary objective is to prevent relapse. If maintenance treatment is not planned, medication should be gradually tapered over 4-6 weeks at the end of this phase.

Several factors are associated with a higher risk of relapse and need to be considered before discontinuation of medication is started. Patients with residual symptoms, patients with significant psychosocial problems, and patients with a history of prior relapse or recurrence are at increased risk for recurrence after continuation therapy. Given the high rates of recurrence of MDE and mania, most patients should be encouraged to strongly consider maintenance treatment.

Maintenance-Phase Procedures
The purpose of maintenance treatment is the prevention of recurrence. Several factors influence the decision to use maintenance treatment. Patients with two or more prior MDEs or two or more prior episodes of mania, patients with more severe episodes, and patients with a risk of suicide should be strongly encouraged to consider maintenance treatment. Patients with multiple mild episodes spaced at long intervals and with complete interinterval recovery may choose not to use maintenance treatment.

Antidepressant and Antimanic Medications Introduction Diagnostic Indications and Contraindications

• Indications for Use of Antidepressant and Antimanic Medications
• Contraindications to Use of Antidepressant and Antimanic Medications
• General Treatment Guidelines Antidepressant Medications: Pharmacological Properties and Evidence for Acute-Phase Efficacy