Treating depression to remission.

Over the last several years, the recommended end point in the treatment of depression has become remission. Patients who achieve remission not only enjoy the benefits of decreased disability and improved functioning in work, family, and social situations, they also have a lower risk of disease progression and relapse. Despite the benefits associated with remission, many patients are left with residual symptoms that prevent them from achieving these benefits. Potential obstacles to reaching remission include diagnostic issues, inadequate treatment, lack of adherence to the treatment regimen, satisfaction with partial improvement, and failure to recognize residual symptoms. Strategies for treating to remission include ensuring appropriate diagnosis, setting treatment goals, selecting antidepressants that are more likely to result in remission, providing patient education and adequate treatment, assessing for residual symptoms, and heeding partial response or lack of response by switching or augmenting treatment.