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Background: Antidepressant medicine prevents the return of depressive indicators, nonetheless solely as long as treatment is sustained. Aims: To search out out whether or not or not cognitive remedy (CT) has a permanent affect and to match this affect in direction of the affect produced by continued antidepressant medicine. Design: Sufferers who responded to CT in a randomized managed trial have been withdrawn from remedy and in distinction all through a 12-month interval with medicine responders who had been randomly assigned to each continuation medicine or placebo withdrawal. Sufferers who survived the continuation half with out relapse have been withdrawn from all remedy and observed all through a subsequent 12-month naturalistic observe-up. Setting: Outpatient clinics on the College of Pennsylvania and Vanderbilt College. Sufferers: An entire of 104 sufferers responded to treatment (57.8% of those initially assigned) and have been enrolled within the subsequent continuation part; sufferers had been initially chosen to represent these with affordable to excessive melancholy. Interventions: Sufferers withdrawn from CT had been allowed no more than three booster lessons all through continuation; sufferers assigned to continuation medicine have been saved at full dosage ranges. Foremost ultimate end result measures: Relapse was outlined as a return, for as a minimum 2 weeks, of indicators ample to satisfy the requirements for fundamental melancholy or Hamilton Despair Score Scale scores of 14 or bigger all through the continuation part. Recurrence was outlined in a comparable vogue all through the following naturalistic observe-up. 20). There have been moreover indications that the affect of CT extends to the prevention of recurrence. Conclusions: Cognitive remedy has a permanent affect that extends previous the tip of treatment. It seems to be as environment friendly as sustaining sufferers on medicine.