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Remission / Continuation Phase Treatment

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Wonderful — Your patient is in remission.


Here are some recommendations regarding Continuation Phase Treatment:
  • According to the 2016 CANMAT guidelines patients without risk factors for recurrence (see below) who receive pharmacotherapy during acute phase treatment should continue their treatment for AT LEAST 6 to 9 months after symptom remission, at the same dose that led to a therapeutic response
  • Patients with a first episode of MDD who enter remission should be followed every 3 months for the first year and at the end of 6-9 months should be evaluated for slow tapering and discontinuation of antidepressant medication (see antidepressant table and go to STOP column for guidance as to how to do this)
  • CANMAT recommends that for those with risk factors for recurrence antidepressants should be continued 2  years or longer
  • Risk factors for recurrence include:
    • frequent, recurrent episodes
    • severe episodes (psychosis, severe impairment, suicidality)
    • chronic episodes
    • presence of comorbidity (psychiatric or other medical conditions)
    • presence of residual symptoms
    • difficult-to-treat episodes
  • For patients who were augmented with antipsychotics, consider gradually tapering and discontinuing the antipsychotics after 6-9 months.



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