 Key features of depression and its management in general practice. |
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"..I
had this once before.."
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Which
of the following statements are true in relation to long-term maintenance
treatment for recurrent major depression?
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1.
Two depressive episodes within 5 years is an indication for long-term
medications.
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2. Long-term treatment should be continued for at least 3 years.
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3.
Antidepressants of all classes are effective in the long-term prevention
of depression.
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4.
Lithium is effective in the long-term prevention of depression.
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5.
A reduced maintenance dose of 30 to 50 percent below the acute dosage
is as effective as a full acute dose in the long-term prevention
of depression.
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4. Lithium is effective in the long-term prevention of depression.
Author's answer: True.
Lithium has been demonstrated to be effective in reducing the frequency of recurrence of major depression. As antidepressants do not require routine monitoring of plasma concentrations, these tend to be the first choice for prophylaxis, though lithium should be used for those patients who continue to suffer recurrence on antidepressants. There is no proven advantage in combining antidepressants and lithium for long-term prevention (1).
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