Dr David Christmas, 27 April 2017:
“With regards to evidence, there is compelling evidence of benefit for maintenance treatment for antidepressants for at least 3 years (Geddes et al, 2003). For many people, there is some support for prophylactic treatment up to 5 years. However, the 15-year recurrence rate for depression is around 85% so the majority of people with depression will get another episode. Whether someone wants to take drugs to prevent another episode or to stop them and see if they’re in that 15% depends on their experience of recurrent depression and whether they’re getting side effects. However, many people when it’s explained that they’ve only got a one-in-six chance of non-recurrence and that maintenance therapy can reduce the risk of recurrence from 41% to 18%, many people are willing to remain on continuation therapy.”
Please note: this was part of wider communication about long term antidepressant treatment and considerations of risk-benefit. I asked Dr Christmas if I could share all of our communications, in time order, and without any edits. Dr Christmas replied: "the obvious issue is that opinions (not 'conclusions') expressed in emails are highly-context specific and I’d be concerned about simply publishing them online where the context is lost or is made to appear irrelevant."