Delayed response & recurrence

Delayed response and recurrence

This graph shows the typical time course in patients with depression. One of the critiques of the monoamine hypothesis of depression is the fact that there is a significant delay in relief of depressive symptoms (most respond after a few weeks). This is in contrast to the relative quick effect the drugs have on their targets (effects seen within hours). In addition, some patients may suffer from a relapse despite taking antidepressant therapy.

Although one should always consider non-compliance as the cause, these quick relapses are often caused by failures in antidepressant therapy. Recurrences are common and are found in 50-70% of the patients who have previously suffered from a depressive episode. When a recurrence occurs, antidepressant therapy may need to be restarted or if the patient is on maintenance therapy, changed to another agent.


Response, resistance, relapse, recurrence, and recovery are the 5 R's of depression.