Go the distance with depression treatment

Patients may require long-term treatment

Clinicians who help patients with the disease say there’s more to the story than recognition of symptoms, following up with an evaluation for depression, and initiating treatment according to established clinical guidelines.

"If depression is recognized, one of the most important problems is that it’s not treated adequately," says Mary Amanda Dew, PhD, a professor of psychiatry in the cardiothoracic division of the University of Pittsburgh Medical Center.

Dew says patients may be given antidepressant therapy and may be responding well to it, but treatment doesn’t last long enough.

"Patients may be given medication for a short period," she says. "But research shows using medication for a longer term may be better."

2 or 3 years of treatment may be needed

Primary care physicians may not keep patients on drug therapy as long as a psychiatrist would, she says, noting that often maintenance therapy for two or three years can be beneficial. Others add that the generalist can do a lot to keep patients on the right track.

"A lot of primary care physicians are quite skilled at treating depression," says Jeffrey E. Kelsey, MD, PhD, assistant professor of medicine and director of the Mood and Anxiety Disease Clinical Trials Program at Emory University’s department of psychiatry and behavior in Atlanta.