Long-term treatment of unipolar depression

Abstract

There is a need for long-term treatment of unipolar depression. With the older medication, tricyclic antidepressants, acute treatment was possible, but unfortunately, the patients did not take the long-term medication, specifically in the correct dosage. With the introduction of modern antidepressants, this dilemma has been partly solved, as the patients are more willing to take their medication. However, compliance studies indicate that this is only the case for a very low percentage. The European Health Regulatory authorities (EMEA) demand for every antidepressant introduced into the market to demonstrate efficacy for at least 6 months. These requirements are not necessary for the American counterpart, the Food and Drug Administration (FDA). Therefore, all the modern medications demonstrate this efficacy, a few of them even for a longer period. The question arises if this benefit can also be achieved for children and adolescents as well as for the elderly. Just a few studies suggest this also for the younger and older population. Side effects as well as the failure of understanding the nature of unipolar depression limit the necessary long-term usage of antidepressants. Education programmes, which indicate that depression is a disease like hypertension, asthma or diabetes, help the patients understand the disease and the triggers, which might accompany the long-term outcome.

During the lecture the unmet needs for treatment of unipolar depression as well as modern outcome studies of recently introduced medication will be presented.