In a recent study that puts antidepressants up against CBT and their effectiveness, the results are promising.
A meta-analysis of 11 randomized controlled trials found no difference in the treatment effects of second-generation antidepressants and cognitive behavioral therapy—alone or in combination—for major depressive disorder, according to a new study in The BMJ.
As a result, both treatments “should be made accessible, either alone or in combination, to primary care patients with major depressive disorder,” researchers recommended.
Each of the studies included in the meta-analysis compared the effectiveness of second-generation antidepressants and cognitive behavioral therapy for initial treatment of patients with major depressive disorder. Ten compared antidepressant monotherapy with cognitive behavioral therapy alone. Three compared antidepressant monotherapy with antidepressant therapy combined with cognitive behavioral therapy.
In total, the studies included 1,511 patients. After accounting for study design and quality, researchers found no statistically significant differences in the effectiveness of the two treatment approaches in response, remission, or change in depression score. No statistically significant differences were found in rates of study discontinuation or discontinuation stemming from a lack of effectiveness.
Researchers wrote that the findings "should be interpreted cautiously given the low strength of evidence for most outcomes." However, they noted that the results are “relatively consistent” with those of similar reviews. They recommended patients have access to both treatments since some may prefer one approach over the other.
- Cognitive behavioral therapy is based on a combination of basic behavioral and cognitive principles. Briefly, it helps patients to understand and examine how their thoughts, moods, and behaviors interact in a way that can result in or worsen depression. Patients are taught how to replace dysfunctional thoughts and behaviors with more adaptive ones, which can reduce distress and improve mood.
Given the range of available treatments for patients with major depressive disorder, each with its own evidence base of benefits and harms, all prescribers should demand high quality evidence of the comparative effectiveness of the available treatments to select and manage the best options for their patients.
Reference: BMJ.org