Wonderful — Your patient is in remission.
Here are some recommendations regarding Continuation Phase Treatment:
- According to the 2016 CANMAT guidelines patients without risk factors for recurrence (see below) who receive pharmacotherapy during acute phase treatment should continue their treatment for AT LEAST 6 to 9 months after symptom remission, at the same dose that led to a therapeutic response
- Patients with a first episode of MDD who enter remission should be followed every 3 months for the first year and at the end of 6-9 months should be evaluated for slow tapering and discontinuation of antidepressant medication (see antidepressant table and go to STOP column for guidance as to how to do this)
- CANMAT recommends that for those with risk factors for recurrence antidepressants should be continued 2 years or longer
- Risk factors for recurrence include:
- frequent, recurrent episodes
- severe episodes (psychosis, severe impairment, suicidality)
- chronic episodes
- presence of comorbidity (psychiatric or other medical conditions)
- presence of residual symptoms
- difficult-to-treat episodes
- For patients who were augmented with antipsychotics, consider gradually tapering and discontinuing the antipsychotics after 6-9 months.