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longterm medication


goose
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Does anyone know the rationale behind keeping people medicated after a bout of depression.

I'm not talking about bi-polar or any other condition where it is advisable to be on a maintenance dose of medication.

I was diagnosed with severe depression 5 years ago. I feel now that I am at a stage where I may no longer need the medication (effexor 225 + seroquil 50). The registrar at the clinic says not to come off the medication until I am 6 months finished therapy. Because the registrars change every 6 months I believe they cannot become familiar with the patients enough to manage their withdrawal, so it is easier to write a prescription.

A lady that works with me has been on anti-depressants for several years, is this the norm?

Im not against medication when needed, I just want to understand the thinking behind keeping someone on longterm antidepressants.

Goose

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Hi goose

Depression has a high recurrence rate, so basically it's to prevent relapse.

One is at a higher risk for relapsing soon after a recovery, which is why it's recommended to continue ADs for 6-9 months after recovery (depending who you ask, some say 1 year.)

What has been found is that the more depressive episodes you have, the greater the likelihood becomes that you will have another. Rough statistics are that once you've had one depressive episode, you have a 50-50 chance of developing another. Once you've had two episodes, the likelihood goes up to 70% and after the third, your chances of recurrence are as high as 90%. (Don't quote me on the accuracy of the stats, but that is the general picture.)

So, the more episodes you've had, the higher risk you become and the thinking is that high-risk people should remain on ADs for life. Even if staying on an AD does not prevent a subsequent episode, it may reduce its severity. If you add psychotherapy to the AD, especially the kind of therapy that gives you tools for dealing with your life, you can also reduce the risk of relapse, or if it happens, the severity.

Of course, the drug companies gleefully push the line that you must stay on ADs.

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Thank you for that Luna, it makes sense to me now.

I do know when they got the mix right for me I was over the moon with the positive effect it had on me.

I also take long-term medication for high BP and for Asthma and I can see the obvious benefits from those also.

Goose

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