Maintenance therapy of depression

This paper summarises findings from a study of maintenance treatment in predominantly neurotic depressives responding to initial treatment with amitriptyline. Patients were continued on amitriptyline for eight months, withdrawn double blind to placebo after two months, or withdrawn overtly to no medication with and without individual psychotherapy from social workers in a factorial design. Continuation significantly reduced early relapse and symptom return, compared with either condition of early withdrawal. Psychotherapy improved social adjustments after eight months in patients who did not relapse, without any significant interactions. Side effects were minimal, except for carbohydrate craving. These findings suggest the tricyclic antidepressants should be routinely continued for several months after drug induced remission.