continuation phase
once remission has been achieved, the patient enters the next two phases of treatment, referred to as the continuation and maintenance phases.
In some guidelines such as CANMAT2009 the two are blended into one.
The APA 2010 guidelines separate the two phases into patients whose depression is simple and those who are more susceptible to a recurrence.
The continuation phase is a precarious period in terms of sustaining remission.
Within the first six months following recovery from the major depressive episode, relapse of symptoms is common.
The proportion of patients with symptoms suggestive of a relapse range from 20 of patients in mixed samples to as many as 85 of severely depression in patients receiving treatment with ECT .
These studies show that relapse rates are higher when antidepressant treatment ( including ECT) is discontinued or reduced in dosage or intensity following recovery.