How long should a person continue to take antidepressant medication? Some patients, especially those who have never been clinically depressed in the past and whose depressions have lasted for relatively short durations, may be able to terminate medication altogether within 6 months. This is best accomplished by gradually tapering the dosage over several weeks' time. A useful guideline is to continue the antidepressant until significant improvements have been evidenced in the patient's life circumstances, such as reestablishing his or her life after a divorce or getting a new job after having been fired.
Patients who have been chronically depressed for years or who have a history of recurrent episodes of depression should probably continue using the antidepressant medication for a year or two. Recurrences of depression following termination are not uncommon, especially because people's conflicts and problems in their life circumstances may not have changed. It may be that the underlying physiologic deficit that accounts for a lack of biological resilience has endured. With new stressors, depression may return and assume an intensity and tenacity that require antidepressant treatment once more. Therefore, some patients would do well to continue using the medications indefinitely, or at least be prepared to restart them when stresses increase and depressive feelings reemerge.
Suggestions for Persons Receiving Treatment for Depression
There are several issues that anyone who receives treatment for clinical depression should consider.
1. If you're in therapy with a non-MD therapist, be sure to assess his or her attitude about antidepressants. It's important for you to be assured that your therapist is open minded about this viable treatment option and willing to refer you to a specialist for medication if it is indicated.
2. A significant number of people can weather depressive episodes and recover from them without medication; some possess sufficient resilience to do it on their own, whereas others can require psychotherapy to accomplish this. But it's important to be willing to consider the use of medications as an option. Thinking of them as resilience restoring agents will save you from falling into the trap of believing that they produce a "false high" or that somehow or other it's braver or smarter to get better without them.
3. If you're on an antidepressant, you must have medical supervision as long as you're taking the medication. Don't stop the medicine on your own. Terminating an antidepressant should be a joint decision between you and your physician. To prevent a sharp recurrence of depression, it's important to taper the dosage, thereby avoiding abrupt discontinuation.
4. If you're seeing a psychiatrist or physician who wants to treat you with an antidepressant, find out what his or her attitude is about other approaches to therapy. You want a specialist who will consider psychotherapy and other strategies such as marital or family therapy that you can use to modify inner and psychosocial conflicts that may be contributing to your condition. For most depressed people, drug treatment alone is not enough.
Antidepressants have revolutionized the treatment of depression. They have also underscored the importance of the role of biological factors in magnifying the intensity and tenacity of depressed moods. They have made it much easier for people to not only recover from depression and its otherwise potentially devastating consequences, but also to develop inner resilience, resolve interpersonal difficulties, and improve their lives within the framework of psychotherapy as well as on their own.