HealthDay News — Teenagers with depression who refuse antidepressants may benefit from cognitive behavioral therapy, according to a study published online April 20 in Pediatrics.
Greg Clarke, PhD, of the Kaiser Permanente Center for Health Research in Portland, Oregon, and colleagues conducted a 5- to 9-week program in which counselors used cognitive behavioral therapy techniques to help teenagers identify unhelpful or depressive thinking and replace those ideas with more realistic, positive thoughts. Between 2006 and 2012, the researchers randomly assigned 212 teens with major depression to receive either the weekly cognitive behavioral therapy or other care for depression, which could have included school counseling or outside therapy. All the teens, who were aged 12 to 18, had either refused antidepressants or stopped taking them.
On average, teens who tried cognitive behavioral therapy recovered 7 weeks faster (22.6 weeks vs 30 weeks) than teens who did not, the investigators found. In addition, the teens who used cognitive behavioral therapy were less likely to require psychiatric hospitalization. After 6 months, 70% of teens in the cognitive behavioral therapy program had recovered, compared with 43% of teens not in the program. Some benefits were still associated with cognitive behavioral therapy after 1 year, although the gap between the 2 groups of teens had tightened, Dr Clarke told HealthDay.
In many cases, depressed teens refuse to take antidepressants, “often because of side effect concerns,” Dr Clarke said. These include warnings going back to 2004 about suicidal thoughts and behavior related to antidepressant use. Other common adverse effects from antidepressants include weight gain and fatigue. “Offering brief cognitive behavioral therapy is an effective alternative,” Dr Clarke said.
Clarke G, DeBar LL, Pearson JA, Dickerson JF, Lynch FL, Gullion CM, Leo MC. Cognitive Behavioral Therapy in Primary Care for Youth Declining Antidepressants: A Randomized Trial. Pediatrics. 2016; doi:10.1542/peds.2015-1851.