Posted by sweetmarie on June 18, 2001, at 5:52:26
In reply to Re: FINALLY GOING » sweetmarie, posted by Cam W. on June 17, 2001, at 9:10:10
> 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.
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> 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.
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> 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.
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> 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. - CamHi Cam,
Thanks for your reply - it WAS of some help.
I think that the idea is that I remain on the successful combination (whether this is the combination I am currently on, or another - if any), long-term. I`ve suffered from moderate - severe depression for most of my life (I`m 34), and the current severe episode has lasted for over 3 years now. I have discontinued meds twice over the past 10 years with disastrous results, so I`m in no hurry to stop taking them any time soon.
The `4 - 12 weeks` you mention is useful; I`ve always been told that the time-span is 3 - 6 weeks. Having said that, I know that the longer the depressive episode has lasted, the longer it takes the meds to have an effect. What I was really after was when the `4 - 12 weeks` (or whatever) is measured from - i.e. is it measured from the onset of taking the med(s), or the beginning of taking the highest dose. In other words, is the period before (hopeful) efficacy measured from the beginning (when a patient begins taking the meds, at a low dose), or from when the meds have been `boosted` to the highest doseage.
Does this make sense? I hope you can get the gist of what I`m asking.
Any `light` on this gratefully appreciated.
Cheers,
Anna.
poster:sweetmarie
thread:55847
URL: http://www.dr-bob.org/babble/20010618/msgs/66946.html