How often do SSRIs and other new-generation antidepressants lose their effect during continuation treatment?
OBJECTIVE: A substantial number of patients who respond to antidepressants experience a relapse despite ongoing pharmacotherapy. The return of symptoms has been interpreted as a loss of the effectiveness of antidepressant activity. However, patients who initially improve while taking antidepressants include an admixture of true drug responders and placebo responders. Consequently, symptom return despite ongoing treatment may not represent a loss of drug effect because the patient may not have experienced a true drug response in the first place. The goal of the present report is to estimate the proportion of relapse attributable to the loss of true drug response versus a loss of placebo response. DATA SOURCES: We reviewed continuation studies of new-generation antidepressants that began as placebo-controlled acute-phase studies. Studies were identified using MEDLINE (English-language articles published from 1980 to 2005 in 23 prespecified journals, using the search terms depression, con
