No Difference Between Antidepressants, CBT for Severe Depression

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In patients with major depressive disorder, patients may be no better of taking antidepressants or cognitive-behavioral therapy (CBT), either alone or in combination.

Gerald Gartlehner, MD, MPH, Danube University, Krebs, Austria, and colleagues conducted a meta-analyses of 11 randomized, controlled trials involving 1,511 patients. Each study compared second-generation antidepressants, such as selective serotonin reuptake inhibitors, and CBT for initial treatment of major depression.

There was no statistically significant differences in effectiveness between second-generation antidepressants and CBT for response, remission, or change in depression score, the researchers reported in The BMJ. In addition, there were not significant differences in discontinuation due to lack of effectiveness.

The researchers said their findings are consistent with other meta-analyses, and recommended that both antidepressant and CBT “should be interpreted cautiously given the low strength of evidence for most outcomes.”

In a related editorial, Mark Sinyor, MD, and colleagues at the University of Toronto state both treatments appear to be equally effective, though the evidence is limited.

They add that policymakers “must acknowledge the World Health Organization's projection that major depressive disorder will be the leading cause of disease burden worldwide by 2030 by taking more meaningful steps towards primary prevention.”

No Difference Between Antidepressants, CBT for Severe Depression
There was no statistically significant differences in effectiveness between second-generation antidepressants and CBT for response or remission.

The available evidence suggests no difference in treatment effects of second generation antidepressants and cognitive behavioral therapy (CBT) either alone or in combination, for patients with major depressive disorder, finds a study in The BMJ.

Some research suggests that patients might prefer treatment with psychotherapy over medication, but evidence about which treatments are most effective is unclear.

So, a team led by Gerald Gartlehner at Danube University, supported by Halle Amick and colleagues at the University of North Carolina and the Research Triangle Institute International, analyzed the results of 11 randomized controlled trials.

Each trial compared second generation antidepressants and CBT for the initial treatment of major depressive disorder and involved a total of 1,511 patients. Differences in study design and quality were taken into account to minimize bias.

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