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The Prophylactic Efficacy of Fluoxetine in Unipolar Depression

Published online by Cambridge University Press:  06 August 2018

S. A. Montgomery ,
H. Dufour ,
S. Brion ,
J. Gailledreau ,
X. Laqueille ,
G. Ferrey ,
P. Moron ,
N. Parant-Lucena ,
L. Singer  and
J. M. Danion
...Show all authors
S. A. Montgomery*
Affiliation:
Department of Psychiatry, St Mary's Hospital Medical School, London
H. Dufour
Affiliation:
Department of Psychiatry, CHU Timone, Marseille
S. Brion
Affiliation:
Department of Psychiatry, Hopital Richaud, Versailles
J. Gailledreau
Affiliation:
Department of Psychiatry, Hopital Richaud, Versailles
X. Laqueille
Affiliation:
Department of Psychiatry, Hopital Richaud, Versailles
G. Ferrey
Affiliation:
Department of Psychiatry, CHS, Eaubonne
P. Moron
Affiliation:
Department of Psychiatry, Hopital de la Grave, Toulouse
N. Parant-Lucena
Affiliation:
Department of Psychiatry, Hopital de la Grave, Toulouse
L. Singer
Affiliation:
Department of Psychiatry, Hospices Civils, Strasbourg
J. M. Danion
Affiliation:
Department of Psychiatry, Hospices Civils, Strasbourg
J. N. Beuzen
Affiliation:
Lilly France, Saint-Cloud
M. A. Pierredon
Affiliation:
Lilly France, Saint-Cloud
*
∗Correspondence
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Extract

The efficacy of antidepressants is measured primarily by their ability to treat the acute symptoms of depression yet the underlying process may take longer to resolve. A period of emotional frailty follows resolution of the acute stage, during which the patient, although apparently symptom-free, is prone to suffer relapse of the original symptoms. Antidepressants should not be stopped immediately a response is observed, but should be given for a longer period to prevent early relapse. In those suffering from recurrent depression, long-term treatment may prevent later recurrences of new episodes of depression.

The distinction between relapse of old symptoms and recurrence of new episodes is of particular importance, both in assessing efficacy of antidepressants during the continuation phase of acute treatment and in the separate assessment of their prophylactic efficacy. Unfortunately, though, many investigations have failed to distinguish between these two distinct phenomena. Klerman & Paykel (1970) emphasised the need to distinguish between early return of depressive symptoms, which they label ‘relapses’, from the later new episodes which they term ‘recurrence’. However, there has been a general lack of systematic investigation of this question, as well as a failure to use sufficiently precise methodology to distinguish between relapse and recurrence. Some studies which purported to be of prophylaxis were in effect only examining the continuation phase of acute treatment.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 153 , Issue S3: Progress in Antidepressant Therapy , September 1988 , pp. 69 - 76
Copyright
Copyright © 1988 The Royal College of Psychiatrists 

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