A 28-year-old woman with recurrent major depressive disorder has achieved remission with sertraline 100 mg daily. She has had three episodes in the past 5 years. According to evidence-based guidelines, what is the recommended duration of continuation and maintenance antidepressant therapy after her third episode?
- A Continue for 6 months after remission, then discontinue
- B Continue for 12 months after remission, then discontinue
- C Continue for at least 2 years, or indefinitely given recurrent episodes ✓
- D Continue for 3 months after remission, then taper
Correct answer: C. Continue for at least 2 years, or indefinitely given recurrent episodes
Explanation
After a third episode of major depression, guidelines recommend long-term or indefinite maintenance antidepressant therapy to prevent relapse. For first episodes, continuation is 6 to 12 months after remission. For two episodes, at least 1 to 2 years. For three or more episodes, indefinite maintenance is recommended. This is a standard guideline in Indian and international postgraduate curricula.
Reference: Kaplan and Sadock's Comprehensive Textbook of Psychiatry, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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