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Pharmaceutisch Weekblad

, Volume 12, Issue 4, pp 128–141 | Cite as

Continuation and maintenance therapy with antidepressive agents

An overview of research
  • Anton J. M. Loonen
  • Goos J. Zwanikken
Reviews

Abstract

The literature was reviewed in order to ascertain the clinical benefits of long-term antidepressant drug treatment in recurrent major depression. Articles describing randomized, controlled, double-blind trials of long-term antidepressant drug treatment, starting at a specified period after recovery from an affective episode, in patients with major depression, were identified and reviewed. The authors describe, evaluate and comment on the design and quality of over 25 identified studies, 18 studies of continuation therapy and 7 of maintenance treatment. The methodological problems which are encountered in this type of research and the sources of bias which invalidate study results, are dealt with systematically. On the basis of this survey, some treatment guidelines and suggestions for future research are given.

Keywords

Affective disorders Antidepressive agents Clinical trials Depression Maintenance 

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References

  1. 1.
    Loonen AJM, Zwanikken GJ. Depressies en hun behandeling [Depressions and their treatment]. Pharm Weekbl 1988;123:918–30.Google Scholar
  2. 2.
    Cole JO. Therapeutic efficacy of antidepressant drugs: a review. JAMA 1964;190:448–55.PubMedGoogle Scholar
  3. 3.
    Davies JM. Antidepressant drugs. In: Kaplan HI, Freedman AM, Sadock BJ, eds. Comprehensive textbook of psychiatry/III. 3rd ed. Baltimore: Williams & Wilkins, 1980:2290–316.Google Scholar
  4. 4.
    Klerman GL, Cole JO. Clinical pharmacology of imipramine and related compounds. Pharmacol Rev 1965;17:101–41.PubMedGoogle Scholar
  5. 5.
    Morris JB, Beck AT. The efficacy of antidepressant drugs: a review of research (1958–1972). Arch Gen Psychiatry 1974;30:667–74.PubMedGoogle Scholar
  6. 6.
    Rogers SC, Clay PM. A statistical review of controlled trials of imipramine and placebo in the treatment of depressive illness. Br J Psychiatry 1975;127:599–603.PubMedGoogle Scholar
  7. 7.
    Coppen A. Strategies for the testing of antidepressants: trials and tribulations. An overview. Acta Psychiatr Scand 1983;68(Suppl 308):27–30.Google Scholar
  8. 8.
    Loonen AJM. Cyclische antidepressiva nader beschouwd: de beoordeling van de werkzaamheid en de waarde van keuzecriteria [Cyclic antidepressants revisited: judging efficacy and criteria of choice]. Tijdschr Psychiatrie 1988;30:460–80.Google Scholar
  9. 9.
    Freeman CP. Prophylaxis against unipolar depression [Editorial]. Br Med J 1984;289:512–4.Google Scholar
  10. 10.
    Work Group to Revise DSM-III of the American Psychiatric Association. Diagnostic and statistical manual of mental disorders (third edition — revised). DSM-III-R. Washington DC: American Psychiatric Association, 1987.Google Scholar
  11. 11.
    Zis AP, Goodwin FK. Major affective disorder as a recurrent illness. Arch Gen Psychiatry 1979;36:835–9.PubMedGoogle Scholar
  12. 12.
    Klein DF, Gittelman R, Quitkin F, Rifkin A. Diagnosis and drug treatment of psychiatric disorders. Adults and children. 2nd. ed. Baltimore: Williams & Wilkins, 1980.Google Scholar
  13. 13.
    Prien RF. Long-term treatment of affective disorders. In: Meltzer HY, ed. Psychopharmacology. The third generation of progress. New York: Raven Press, 1987:1051–8.Google Scholar
  14. 14.
    Mindham RH. Tricyclic antidepressants. In: Tyrer PJ, ed. Drugs in psychiatric practice. London: Butterworths, 1982:177–218.Google Scholar
  15. 15.
    Davis JM. Overview: maintenance therapy in psychiatry. II. Affective disorders. Am J Psychiatry 1976;133:1–13.PubMedGoogle Scholar
  16. 16.
    Kleinman I, Anath J. Tricyclic continuation and maintenance therapy in unipolar depression. Psychomatics 1981;22:1031–6.Google Scholar
  17. 17.
    Mindham RHS. The use of drugs in the prevention of relapse in affective disorders. Int J Ment Health 1987;6:88–103.Google Scholar
  18. 18.
    Müller-Oerlinghausen B. Antidepressive Langzeitmedikation, unter besonderer Berücksichtigung der Lithiumsalze. Nervenarzt 1978;49:507–17.PubMedGoogle Scholar
  19. 19.
    Quitkin F, Rifkin A, Klein DF. Prophylaxis of affective disorders. Current status of knowledge. Arch Gen Psychiatry 1976;33:337–41.PubMedGoogle Scholar
  20. 20.
    Kuhn R. Über die Behandlung depressiver Zustände mit einem Iminodibenzylderivat (G 22355). Schweiz Med Wochenschr 1957;87:1135–40.PubMedGoogle Scholar
  21. 21.
    Angst J. A clinical analysis of the effects of tofranil in depression. Longitudinal and follow-up studies. Treatment of blood relations. Psychopharmacologia 1961;2:381–407.PubMedGoogle Scholar
  22. 22.
    Angst J, Dittrich A, Grof P. Course of endogenous affective psychoses and its modification by prophylactic administration of imipramine and lithium. Int Pharmacopsychiatry 1969;2:1–11.Google Scholar
  23. 23.
    Hordern A, Burt CG, Gordon WF, Holt NF. Amitriptyline in depressive states: six-month treatment results. Br J Psychiatry 1964;110:641–7.PubMedGoogle Scholar
  24. 24.
    Kiloh LG, Ball JRB. Depression treated with imipramine: a follow-up study. Br Med J 1961;1:168–71.Google Scholar
  25. 25.
    Kiloh LG, Child JP, Latner G. Endogenous depression treated with iproniazid: a follow-up study. J Ment Sci 1960;106:1425–8.PubMedGoogle Scholar
  26. 26.
    Seager CP, Bird RL. Imipramine with electrical treatment in depression — a controlled trial. J Ment Sci 1962;108;704–7.PubMedGoogle Scholar
  27. 27.
    Krog-Meyer I, Kirkegaard C, Kijne B, et al. Prediction of relapse with the TRH test and prophylactic amitriptyline in 39 patients with endogenous depression. Am J Psychiatry 1984;141:945–8.PubMedGoogle Scholar
  28. 28.
    World Health Organization. International classification of diseases. Manual of the international statistical classification of diseases, injuries, and causes of death. 8th ed. 1965. Geneva: World Health Organization, 1969.Google Scholar
  29. 29.
    Imlah NW, Ryan E, Harrington JA. The influence of antidepressant drugs on the response to electroconvulsive therapy and on subsequent relapse rates. In: Bente D, Bradley PB, Higgins SE, eds. Proceedings of the fourth meeting of the Collegium Internationale Neuro-Psychopharmacologicum, Birmingham, September 1964. Amsterdam: Elsevier Science Publishers, 1965:438–42. (Neuro-Psychopharmacology; vol. 4).Google Scholar
  30. 30.
    Kay DWK, Fahy T, Garside RF. A seven-month double-blind trial of amitriptyline and diazepam in ECT-treated depressed patients. Br J Psychiatry 1970;117:667–71.PubMedGoogle Scholar
  31. 31.
    Mindham RHS, Howland C, Shepherd M. An evaluation of continuation therapy with tricyclic antidepressants in depressive illness. Psychol Med 1973;3:5–17.PubMedGoogle Scholar
  32. 32.
    Mindham RHS. Continuation therapy with tricyclic antidepressants in relapsing depressive illness. Bibliotheca Psychiatry 1981;160:49–55.Google Scholar
  33. 33.
    Mindham RHS, Howland C, Shepherd M. Continuation therapy with tricyclic antidepressants in depressive illness. Lancet 1972;2:854–5.PubMedGoogle Scholar
  34. 34.
    Medical Research Council. Clinical trial of the treatment of depressive illness. Report to the Medical Research Council by its clinical psychiatry committee. Br Med J 1965;1:881–6.Google Scholar
  35. 35.
    DiMascio A, Klerman GL, Prusoff B. Relative safety of amitriptyline in maintenance treatment of depression. J Nerv Ment Dis 1975;160:34–41.PubMedGoogle Scholar
  36. 36.
    Klerman GL, DiMascio A, Weissman M, Prusoff B, Paykel ES. Treatment of depression by drugs and psychotherapy. Am J Psychiatry 1974;131:186–91.PubMedGoogle Scholar
  37. 37.
    Paykel ES, DiMascio A, Haskell D, Prusoff BA. Effects of maintenance amitriptyline and psychotherapy on symptoms of depression. Psychol Med 1975;5:67–77.PubMedGoogle Scholar
  38. 38.
    Paykel ES, DiMascio A, Klerman GL, Prusoff BA, Weissman MM. Maintenance therapy of depression. Pharmacopsychiatry 1976;9:127–36.Google Scholar
  39. 39.
    Paykel ES, Tanner J. Life events, depressive relapse and maintenance treatment. Psychol Med 1976;6:481–5.PubMedGoogle Scholar
  40. 40.
    Weissman MM, Klerman GL, Paykel ES, Prusoff BA, Hanson B. Treatment effects on the social adjustment of depressed patients. Arch Gen Psychiatry 1974;30:771–8.PubMedGoogle Scholar
  41. 41.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 2nd ed. Washington: American Psychiatric Association, 1968.Google Scholar
  42. 42.
    Coppen A, Ghose K, Montgomery S, Rama Rao VA, Bailey J, Jorgensen A. Continuation therapy with amitriptyline in depression. Br J Psychiatry 1978;133:28–33.PubMedGoogle Scholar
  43. 43.
    Stein MK, Rickeis K, Weise CC. Maintenance therapy with amitriptyline: a controlled trial. Am J Psychiatry 1980;137:370–1.PubMedGoogle Scholar
  44. 44.
    Feighner JP, Robins E, Guze SB, Woodruff RA, Winokur G, Munoz R. Diagnostic criteria for use in psychiatric research. Arch Gen Psychiatry 1972;26:57–63.PubMedGoogle Scholar
  45. 45.
    Glen AIM, Johnson AL, Shepherd M. Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a randomized, double-blind, controlled trial. Psychol Med 1984;14:37–50.PubMedGoogle Scholar
  46. 46.
    Medical Research Council Drug Trials Subcommittee. Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a controlled clinical trial. Psychol Med 1981;11:409–16.Google Scholar
  47. 47.
    Spitzer RL, Endicott J, Robins E. Research diagnostic criteria (RDC) for a selected group of functional disorders. 3rd ed. New York: New York State Psychiatric Institute, Biometrics Research Division, 1977.Google Scholar
  48. 48.
    Grof P, Vinar O. Maintenance and prophylactic imipramine doses in recurrent depressions. Acta Nerv Sup 1966;8:383–5.Google Scholar
  49. 49.
    Covi L, Lipman RS, Derogatis LR, Smith JE, Pattison JH. Drugs and group psychotherapy in neurotic depression. Am J Psychiatry 1974;131:191–8.PubMedGoogle Scholar
  50. 50.
    Coppen A, Montgomery SA, Gupta RK, Bailey JE. A double-blind comparison of lithium carbonate and maprotiline in the prophylaxis of the affective disorders. Br J Psychiatry 1976;128:479–85.PubMedGoogle Scholar
  51. 51.
    Coppen A, Gupta R, Montgomery S, Bailey J. A double blind comparison of lithium carbonate and ludiomil® in the prophylaxis of unipolar affective illness. Pharmacopsychiatry 1976;9:94–9.Google Scholar
  52. 52.
    Coppen A, Ghose K, Rama Rao VA, Bailey J, Peet M. Mianserin and lithium in the prophylaxis of depression. Br J Psychiatry 1978;133:206–10.PubMedGoogle Scholar
  53. 53.
    Wood K, Swade C, Abou-Saleh M, Milln P, Coppen A. Drug plasma levels and platelet 5-HT uptake inhibition during long-term treatment with fluvoxamine or lithium in patients with affective disorders. Br J Clin Pharmacol 1983;15:365S-8S.PubMedGoogle Scholar
  54. 54.
    Prien RF, Klett J, Caffey EM Jr. Lithium carbonate and imipramine in prevention of affective episodes. A comparison in recurrent affective illness. Report of the Veterans Administration and National Institute of Mental Health Collaborative Study Group. Arch Gen Psychiatry 1973;29:420–5.PubMedGoogle Scholar
  55. 55.
    Prien RF, Kupfer DJ, Mansky PA, et al. Drug therapy in the prevention of recurrences in unipolar and bipolar affective disorders. Report of the NIMH Collaborative Study Group comparing lithium carbonate, imipramine, and a lithium carbonate-imipramine combination. Arch Gen Psychiatry 1984;41:1096–104.PubMedGoogle Scholar
  56. 56.
    Prien RF. NIMH Report. Five-center study clarifies use of lithium, imipramine for recurrent affective disorders. Hosp Commun Psychiatry 1984;35:1097–8.Google Scholar
  57. 57.
    Prien RF. Research overview of drug therapy in recurrent and chronic depression. In: Kemali D, Racagni G, eds. Chronic treatments in neuropsychiatry. New York: Raven Press, 1985;121–30. (Costa E, Greengard P, eds. Advances in biochemistry and psychopharmacology; vol. 40).Google Scholar
  58. 58.
    Prien RF, Kupfer DJ. Continuation drug therapy for major depressive episodes: how long should it be maintained? Am J Psychiatry 1986;143:18–23.PubMedGoogle Scholar
  59. 59.
    Spitzer R, Endicott J, Robbins E. Research diagnostic criteria for a selected group of functional disorders. 2nd ed. New York: New York State Psychiatric Institute, Biometrics Research Division, 1975.Google Scholar
  60. 60.
    Lendresse P, Spriet A, Lemarié JC. Continuation therapy with nomifensine in depression: a multicenter double blind study. World Psychiatric Association Regional Symposium on Affective Disorders. Athens, 13–17 October 1985:abstract S165.Google Scholar
  61. 61.
    Doogan DP, Caillard V. Sertraline in the prevention of relapse in major depression. Psychopharmacology 1988;96(Suppl):S271.Google Scholar
  62. 62.
    Task Force on Nomenclature and Statistics. Diagnostic and statistical manual of mental disorders. 3rd ed. (DSM-III). Washington DC: American Psychiatric Association, 1980.Google Scholar
  63. 63.
    Quitkin FM, Kane J, Rifkin A, Ramos-Lorenzi JR, Nayak DV. Prophylactic lithium carbonate with and without imipramine for bipolar I patients. A double-blind study. Arch Gen Psychiatry 1981;38:902–7.PubMedGoogle Scholar
  64. 64.
    Kane JM, Quitkin FM, Rifkin A, et al. Prophylactic lithium with and without imipramine for bipolar I patients: a double-blind study. Psychopharmacol Bull 1981;17(1):144–5.PubMedGoogle Scholar
  65. 65.
    Spitzer RL, Endicott J, Robins E. Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 1978;35:773–82.PubMedGoogle Scholar
  66. 66.
    Montgomery SA, Roy D, Montgomery DB. The prevention of recurrent suicidal acts. Br J Clin Pharmacol 1983;15(Suppl 2):183S-8S.PubMedGoogle Scholar
  67. 67.
    Othmer E, Othmer SC, Stern WC, Van Wyck Fleet J. Long-term efficacy and safety of bupropion. J Clin Psychiatry 1983;44:153–6.Google Scholar
  68. 68.
    Guelfi JD, Dreyfus JP, Pichot P. Fluvoxamine and imipramine: results of a long-term controlled trial. Int Clin Psychopharmacol 1987;2:103–9.PubMedGoogle Scholar
  69. 69.
    Feighner JP, Merideth CH, Hendrickson G. Maintenance antidepressant therapy. A double-blind comparison of trazodone and imipramine. J Clin Psychopharmacol 1981;1(Suppl 6):45S-8S.Google Scholar
  70. 70.
    Georgotas A, McCue RE, Cooper TB, Nagachandran N, Chang I. How effective and safe is continuation therapy in elderly depressed patients? Factors affecting relapse rate. Arch Gen Psychiatry 1988;45:929–32.PubMedGoogle Scholar
  71. 71.
    Quitkin F, Rifkin A, Kane J, Ramos-Lorenzi JR, Klein DF. Prophylactic effect of lithium and imipramine in unipolar and bipolar II patients: a preliminary report. Am J Psychiatry 1978;135:570–2.PubMedGoogle Scholar
  72. 72.
    Kane JM, Quitkin FM, Rifkin A, Ramos-Lorenzi JR, Nayak DD, Howard A. Lithium carbonate and imipramine in the prophylaxis of unipolar and bipolar II illness. A prospective, placebo-controlled comparison. Arch Gen Psychiatry 1982;39:1065–9.PubMedGoogle Scholar
  73. 73.
    Quitkin F, Rifkin A, Kane J, et al. The prophylactic effect of lithium and imipramine in bipolar II and unipolar patients: a preliminary report. Psychopharmacol Bull 1979;15(2):35–9.Google Scholar
  74. 74.
    Quitkin FM, Kane JM, Rifkin A, et al. Lithium and imipramine in the prophylaxis of unipolar and bipolar II depression: a prospective, placebo-controlled comparison. Psychopharmacol Bull 1981;17(1):142–4.Google Scholar
  75. 75.
    Björk K. The efficacy of zimeldine in preventing depressive episodes in recurrent major depressive disorders — a double-blind placebo-controlled study. Acta Psych Scand 1983;68(Suppl 308):182–9.Google Scholar
  76. 76.
    Danion JM, Pierredon MA, Tatossian A, Singer L. Prevention of recurrent major depression with fluoxetine: methodological aspects. World Psychiatric Association Regional Symposium on Affective Disorders. Athens, 13–17 October 1985:abstract S164.Google Scholar
  77. 77.
    Montgomery SA, Dufour H, Brion S, et al. The prophylactic efficacy of fluoxetine in unipolar depression. Br J Psychiatry 1988;153(Suppl 3):69–76.Google Scholar
  78. 78.
    Frank E, Kupfer DJ. Efficacy of combined imipramine and interpersonal psychotherapy. Psychopharmacol Bull 1987;23(1):4–7.PubMedGoogle Scholar
  79. 79.
    Frank E, Prien RF, Kupfer DJ, Alberts L. Implications of noncompliance on research in affective disorders. Psychopharmacol Bull 1985;21(1):37–42.PubMedGoogle Scholar
  80. 80.
    Frank E, Kupfer DJ. Psychotherapeutic approaches to treatment of recurrent unipolar depression: work in progress. Psychopharmacol Bull 1986;22(3):558–63.PubMedGoogle Scholar
  81. 81.
    Frank E, Kupfer DJ. Maintenance treatment of recurrent unipolar depression: pharmacology and psychotherapy. In: Kemali D, Racagni G, eds. Chronic treatments in neuropsychiatry. New York: Raven Press, 1985;139–51. (Costa E, Greengard P, eds. Advances in biochemistry and psychopharmacology; vol. 40).Google Scholar
  82. 82.
    Kupfer DJ, Frank E. Relapse in recurrent unipolar depression. Am J Psychiatry 1987;144:86–8.PubMedGoogle Scholar
  83. 83.
    Frank E, Kupfer DJ, Perel JM. Early recurrence in unipolar depression. Arch Gen Psychiatry 1989;46:397–400.PubMedGoogle Scholar
  84. 84.
    Kupfer DJ, Frank E, Perel JM. The advantage of early treatment intervention in recurrent depression. Arch Gen Psychiatry 1989;46:771–5.PubMedGoogle Scholar
  85. 85.
    Klerman GL, Weissman MM, Rounsaville BJ, et al., eds. Interpersonal psychotherapy of depression. New York: Basic Books, 1984.Google Scholar
  86. 86.
    Greil W, Haag M, Huber D, Schmidt St. Maintenance treatment in affective disorders. Overview and design of a collaborative study. Pharmacopsychiatry 1986;19:167–9.Google Scholar
  87. 87.
    Angst J. Ungelöste Probleme bei der Indikationsstellung zur Lithiumprophylaxe affektiver und schizoeffektiver Erkrankungen. Bibl Psychiatr 1981;161:34–44.Google Scholar
  88. 88.
    Georgotas A, McCue RE, Cooper TB. A placebocontrolled comparison of nortriptyline and phenelzine in maintenance therapy of elderly depressed patients. Arch Gen Psychiatry 1989;46:783–6.PubMedGoogle Scholar
  89. 89.
    Bialos D, Giller E, Jatlow P, Docherty J, Harkness L. Recurrence of depression after discontinuation of longterm amitriptyline treatment. Am J Psychiatry 1982;139:325–9.PubMedGoogle Scholar
  90. 90.
    Giller E Jr, Bialos D, Harkness L, Jatlow P, Waldo M. Long-term amitriptyline in chronic depression. Hillside J Clin Psychiatry 1985;7:16–33.PubMedGoogle Scholar
  91. 91.
    Cook BL, Helms PM, Smith RE, Tsai M. Unipolar depression in the elderly. Reoccurrence on discontinuation of tricyclic antidepressants. J Affect Disord 1986;10:91–4.PubMedGoogle Scholar
  92. 92.
    Loonen AJM, Zwanikken GJ. Farmaca, psychofarmaca, klinisch onderzoek. Ontwikkeling, beproeving en toepassing van (psycho)farmaca [Drugs, psychotropic drugs, clinical evaluation and use of (psychotropic) drugs]. 's-Hertogenbosch: Wulco, 1987.Google Scholar
  93. 93.
    Pocock SJ. Clinical trials. A practical approach. Chichester: John Wiley & Sons, 1983.Google Scholar
  94. 94.
    Spilker B. Guide to clinical studies and developing protocols. New York: Raven Press, 1984.Google Scholar
  95. 95.
    Wittenborn JR. Guidelines for clinical trials in psychopharmacology. In: Lipton MA, DiMascio A, Killam KF, eds. Psychopharmacology: a generation of progress. New York: Raven Press, 1978:833–40.Google Scholar
  96. 96.
    Bielski RJ, Friedel RO. Prediction of tricyclic antidepressant response. A critical review. Arch Gen Psychiatry 1976;33:1479–89.PubMedGoogle Scholar
  97. 97.
    Consensus Development Panel. Consensus conference on electroconvulsive therapy. JAMA 1985;254:2103–8.Google Scholar
  98. 98.
    Fawcett J, Scheftner W. Efficacy in depression. ECT versus antidepressants. Psychopharmacol Bull 1986;22(2):468–9.Google Scholar
  99. 99.
    Nelson JC, Charney DS. The symptoms of major depressive illness. Am J Psychiatry 1981;138:1–13.PubMedGoogle Scholar
  100. 100.
    Sinaikin PM. A clinically relevant guide to the differential diagnosis of depression. J Nerv Ment Dis 1985;173:199–211.PubMedGoogle Scholar
  101. 101.
    Stern SL, Rush AJ, Mendels J. Toward a rational pharmacotherapy of depression. Am J Psychiatry 1980;137:545–52.PubMedGoogle Scholar
  102. 102.
    Marini JL, Sheard MH, Bridges CI, Wagner E. An evaluation of the double-blind design in a study comparing lithium carbonate with placebo. Acta Psychiatr Scand 1976:53:343–54.PubMedGoogle Scholar
  103. 103.
    Hughes JR, Krahn D. Blindness and the validity of the double-blind procedure. J Clin Psychopharmacology 1985;5:138–42.Google Scholar
  104. 104.
    Christodoulou GN, Lykouras EP. Abrupt lithium discontinuation in manic-depressive patients. Acta Psychiatr Scand 1982;65:310–4.PubMedGoogle Scholar
  105. 105.
    Goodnick PJ. Clinical and laboratory effects of discontinuation of lithium prophylaxis. Acta Psychiatr Scand 1985;71:608–14.PubMedGoogle Scholar
  106. 106.
    Dilsaver SC, Kronfol Z, Sackellares JC, Greden JF. Antidepressant withdrawal syndromes: evidence supporting the cholinergic overdrive hypothesis. J Clin Psychopharmacol 1983;3:157–64.PubMedGoogle Scholar
  107. 107.
    Mirin SM, Schatzberg AF, Creasey DE. Hypomania and mania after withdrawal of tricyclic antidepressants. Am J Psychiatry 1981;138:87–9.PubMedGoogle Scholar
  108. 108.
    Tyrer P. Clinical effects of abrupt withdrawal from tricyclic antidepressants and monoamine oxidase inhibitors after long-term treatment. J Affect Disord 1984;6:1–7.PubMedGoogle Scholar
  109. 109.
    Baastrup PC, Poulsen JC, Schou M, Thomsen K, Amdisen A. Prophylactic lithium: double-blind discontinuation in manic-depressive and recurrent-depressive disorders. Lancet 1970;2:326–30.PubMedGoogle Scholar
  110. 110.
    Coppen A, Noguera R, Bailey J, et al. Prophylactic lithium in affective disorders: controlled trial. Lancet 1971;2:275–9.PubMedGoogle Scholar
  111. 111.
    Coppen A, Abou-Saleh MT, Milln P, et al. Lithium continuation therapy following electroconvulsive therapy. Br J Psychiatry 1981;139:284–7.PubMedGoogle Scholar
  112. 112.
    Davidson J, Raft D. Use of phenelzine in continuation therapy. Neuropsychobiology 1984;11:191–4.PubMedGoogle Scholar
  113. 113.
    Harrison W, Rabkin J, Stewart JW, McGrath PJ, Tricamo E, Quitkin P. Phenelzine for chronic depression: a study of continuation treatment. J Clin Psychiatry 1986;47:346–9.PubMedGoogle Scholar
  114. 114.
    Robinson DS, Kayser A, Bennett B, et al. Maintenance phenelzine treatment of major depression: an interim report. Psychopharmacol Bull 1986;22(3):553–7.Google Scholar
  115. 115.
    Wehr TA, Goodwin FK. Can antidepressants cause mania and worsen the course of affective illness? Am J Psychiatry 1987;144:1403–11.PubMedGoogle Scholar

Copyright information

© Royal Dutch Association for Advancement of Pharmacy 1990

Authors and Affiliations

  • Anton J. M. Loonen
    • 1
  • Goos J. Zwanikken
    • 2
  1. 1.Psychiatric Hospital Reinier van Arkel/VoorburgGB Vughtthe Netherlands
  2. 2.Department of PsychiatryCatholic University of NijmegenHB Nijmegenthe Netherlands

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