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Letters
July 28, 1999

Relapse of Depressive Symptoms After Discontinuing Sertraline—Reply

Author Affiliations
 

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;282(4):323-324. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-4-jbk0728

In Reply: We disagree with the statement by Drs Baldessarini and Viguera that the maintenance effects of sertraline in our study represent only "moderate sparing of relapse." A 4-fold reduction in depression recurrence (23% with placebo vs 6% with sertraline) represents a substantial reduction in risk. Further, we are not as surprised as Baldessarini and Viguera at the relatively low relapse rate observed when switching to placebo in our study, which probably resulted from several factors: (1) patients randomized to sertraline or placebo were a compliant and responsive subset (38%) of the original patient sample, (2) placebo treatment was not a "no treatment" condition since study participation necessarily involved a high degree of nonspecific supportive therapy, and (3) chronicity may constitute less of an immediate relapse risk than a high number of prior episodes.

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