Presse Med
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Approximately 80% of the patients who have a first episode of major depression will have at least one more. The lifetime average is 4 episodes. Nevertheless, despite this high risk of relapse, often severe and disabling, only half the patients with recurrent major depression receive prophylactic treatment. ⋯ Lithium and carbamazepine may be prescribed as second-line preventive treatment. Although we lack controlled studies of the prophylactic efficacy of psychotherapies in recurrent depression, interpersonal, cognitive and behavioral psychotherapies have been shown to be effective in reducing the relapse rate, especially when associated with antidepressants. Treatment duration should be determined individually, taking into account the patient's risk profile and international and national guidelines.