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Prozac 10 mg capsules in 2006. It did not prevent recurrences; rather, it was an aid to management of depression-associated insomnia.14 This trial is not included in our review. The NICE recommendations for prevention and treatment of SAD are Is diflucan available over the counter in ireland unclear, particularly with respect to the use of benzodiazepines. evidence about the effect of benzodiazepines on sleep has been accumulating over the Prozac 90 Pills 20mg $99 - $1.1 Per pill past 10 years, and results have been inconsistent. Studies with double-blind placebo-controlled designs seem to show a reduction in sleep latency with use of these drugs.15,16 An earlier study16 using computer-assisted phone interviewing of patients with SAD found that taking benzodiazepines were more likely to report a full night of interrupted sleep at week 12 than patients who did not take benzodiazepines. This difference may reflect cheap prozac canada more serious adverse events, or, most likely, less treatment burden with benzodiazepines. Nevertheless, benzodiazepines have not been proven to reduce the risk of SAD. A Cochrane review the use and safety of benzodiazepines in adults found that there was no consistent reduction in the risk of SAD with these drugs.17 Other drugs, such as the nonsteroidal anti-inflammatory drug diclofenac, are less well studied and might be more beneficial, although the evidence is not as robust, so results have to be interpreted with caution. The results of this systematic review suggest that pharmacotherapy may have no effect on the risk of relapse during treatment for SAD, although pharmacotherapy has not completely abolished the risk associated with depression. Patients should be encouraged to continue have an assessment every four weeks. A number of interventions are considered helpful but might be more effective in people with severe depression, for example, cognitive behavioural therapy, interpersonal therapy or family therapy. However, these interventions are associated with more problems the patient and clinician, take longer to begin on. This might affect retention, as will the possibility of a relapse. There is very limited evidence on the effect of long-acting antidepressants on relapse, and very little evidence on the effect of medications given for other symptoms on relapse. The available evidence tends to be inconsistent and of short duration. The effect medications on relapse is not well established and the available data are less reliable than for antidepressants. Depression is a potentially debilitating illness with high incidence of relapse. It is important for clinicians to understand the risk of relapse during treatment for this chronic illness, to consider what interventions might have a greater or lesser effect on the relapse rate and to take appropriate steps prevent or treat relapse. Conclusions Our review concluded that there is a positive association between use of anti-depressant medication and an increased risk of a recurrent episode major depression. This effect appears to hold in all patients, regardless of age, dose, type the drug or severity of disease. This study has some limitations. Since the data are from observational studies the association cannot be generalised to a given population due the heterogeneity of studies, but they do illustrate that long-term antidepressant use increases the risk of a recurrence depression and that this risk is independent of other factors, including the use of drugs for other disorders, the age at which patients stop therapy, medication side effects and duration of illness. Long-term use of antidepressants is associated with a higher relapse rate than short-term use but this does not mean that people who stop taking medication do not relapse, but they probably do not experience a recurrence at the same level.