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Should older people who respond to short-term antidepressant therapy continue long-term maintenance therapy? This question was addressed in a randomized trial from Pittsburgh that included 116 patients (age, ≥70) with major depression who had responded to short-term treatment with paroxetine and psychotherapy.
Patients received one of four maintenance treatments for 2 years or until major depression recurred: paroxetine plus monthly psychotherapy; paroxetine plus monthly clinical-management sessions; placebo plus psychotherapy; and placebo plus clinical-management sessions. (Clinical-management sessions were discussions about symptoms and side effects, without specific psychotherapy.) Major depression recurred in 35%, 37%, 68%, and 58% of pa…