Adolescence is such a tough time. The average teen is struggling with school work, sports team performance, acne, sexuality issues, relationship issues, figuring out who they are while trying to get along with mom and dad. When depression hits - it can really complicate these issues. When resistant depression hits - it can be the ultimate challenge for the teen patient and their doctor. And of course, suicide always lurks as a possibility.
Right now, fluoxetine (Prozac) is considered to be the only medication FDA approved to treat resistant depression in teens. But many teens don't respond to this therapy. The TORDIA study (Treatment of SSRI-Resistant Depression in Adolescents) now offers ome valuable information in how these teens can be helped. The trial looked at teens who were not responsive to the first 2 weeks of fluoxetine treatment for resistant depression. The 334 patients then received either:
- A different SSRI for 12 weeks
- A different SSRI plus CBT (Cognitive Behavioral Therapy)
- Effexor plus CBT
Adding CBT to the treatment produced a 55% higher rate of response than just switching to a new medication (which only yielded a 41% response). Adding the CBT worked when giving Paxil, Celexa or Prozac. There were other findings in this study and some problems that forced an extension of the study to be temporarily halted. But the CBT clearly enhanced medications and is worthy of being included when treating teens for serious depression.