MODERN APPROACHES TO THE RELAPSE PREVENTION THERAPY OF RECURRENT DEPRESSION

Abstract

The purpose of the article is to systematize the data available in the literature on the goals, objectives and methods of relapse preventing therapy of recurrent depressive disorder (RDD). The relevance of the article is determined by the fact that achieving and maintaining remission, as well as preventing relapses of the disease, are the key to successful RDD therapy. However, in recent years, most studies and publications relate to the therapy of асute depression. Much less attention is paid to the prevention of relapses. Based on the analysis of the available literature data, including evidence-based studies and clinical recommendations, the results of our own research and clinical experience, approaches to relapse preventing therapy of depression within the framework of a single episode and RDD are described. The necessity of long-term relapse preventing therapy is justified, its stages (continued and maintenance therapy), their goals and objectives, the possibilities of using various pharmacological and non-pharmacological methods are described. Based on the results of our own study, which evaluated the quality of remission in the treatment of new-generation antidepressants and amitriptyline, the advantage of new-generation antidepressants over amitriptyline in terms of the quality of remission was shown. The study also revealed a decrease of insight and compliance among patients with persistent high quality remission when treated with a new generation of antidepressants. The literature data on adverse events associated with the long-term use of antidepressants as weight gain, the effect on the thyroid axis and a decrease in bone mineral density with the formation of an increased risk of fractures are analyzed. Recommendations for relapse preventing therapy were given.