American Board of Internal Medicine (ABIM) Certification Practice Exam

For a patient with a single episode of unipolar major depression, how long should they continue taking antidepressants after acute treatment?

1. 3 months

2. 6 months

3. 1 year

4. Indefinitely

The correct answer is: 6 months

For a patient with a single episode of unipolar major depression, the recommended duration for continuing antidepressants after successful acute treatment is typically around six months. This guideline is based on the understanding that while acute treatment can alleviate symptoms, there is a significant risk of relapse after the initial episode. Continuing treatment for this duration helps to consolidate recovery and lower the chances of recurrence, especially in individuals who have not experienced multiple episodes in the past. Research indicates that continuing antidepressant therapy for at least six months after achieving remission significantly reduces the risk of relapse compared to stopping treatment earlier. This approach is particularly critical in ensuring that the patient remains stable and does not face the challenges associated with a return of depressive symptoms. Longer durations of treatment, such as one year or indefinitely, are generally recommended for individuals with multiple episodes of depression or those with a higher risk of relapse. In contrast, stopping treatment too soon, such as after three months, might not provide adequate risk mitigation for relapse in a patient who has had only one episode. Thus, the six-month duration strikes a balance by allowing sufficient time for recovery while not extending treatment unnecessarily in a patient with a more straightforward clinical history.