The risk of recurrence of depression must be balanced against the problems and risks of maintenance therapy. The goal of maintenance therapy is to prevent new episodes of depression. A review of the literature reveals that the existing data does not provide sufficient evidence to demonstrate the usefulness of tricyclic maintenance therapy. Nonetheless, it would be premature to conclude that this type of treatment is not useful. Further studies of maintenance therapy are indicated and should include a continuation period of at least 16 weeks during which patients are symptom free (that is, Global Assessment Scale 71 or more). In the interim, each patient should be evaluated individually to determine the optimum duration of treatment.
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