For Teens, Adding Therapy to Drugs Boosts Effectiveness, Safety
The research adventure continues into two key questions in depression treatment: Are antidepressants safe and effective for kids? And, Will drugs alone provide relief?
Bottom line first
According to findings published in Archives of General Psychiatry, depressed teens recover well with Prozac or cognitive behavioral therapy (CBT), but respond best when the two are combined. When therapy is added to Prozac treatment, any increased risk of suicidal thinking related to the drug disappears.
This study in 50 words or less
Researchers gave depressed adolescents fluoxetine (Prozac), CBT or both. More of those receiving both treatments recovered than those getting either one, though at 36 weeks over 80 percent in all groups had recovered. The advantage of the combination was greatest at 12 weeks. Suicidal thoughts initially increased in the drug-only group, but adding therapy eliminated that effect.
Yes, but. . .
- As depression studies go, this one is pretty clean: It was sponsored by the National Institues of Health, had no funding from the pharmaceutical industry and involved a diverse group of teens.
- The report studied data collected only through 36 weeks; longer term results were not analyzed.
- Like any study of psychotherapy, this one could not be sufficiently blinded--meaning those getting therapy knew they were getting therapy. The drug therapy was double-blinded for part of the study.
- The findings apply to moderate to severe depression, not the more common milder type.
- Only Prozac was tested; it's not clear whether treatment with other drugs in the SSRI class would shows the same results.
So what are you going to do about it?
The current best practice recommendations call for a combination of anti-depressants and cognitive behavioral therapy for moderate to severe depression, so this study confirms the benefit of this dual approach.
In recent years, studies have found conflicting results over the question of whether teens taking antidepressants could have more suicidal thoughts. This study confirms a possible increase in risk, but suggests it can be eliminated by adding CBT, especially early in the treatment.
Read this excellent SharePost by our medical expert, Chris Ballas, M.D. It provides a clear overview of research into teen depression, drugs and suicidal thinking.
Our site has gathered information about children and depression, including a video that addresses the drug/suicidal thinking controversy.