Switching from an antidepressant medication to psychotherapy or vice versa may improve symptoms in chronically depressed patients who prove unresponsive to their initial treatment, according to an article in the May issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
"A substantial proportion of patients treated for depression do not respond to the initial trial of either an antidepressant medication or depression-targeted psychotherapy," according to background information in the article. For those resistant to treatment there are several options available, including switching medication, enhancing or combining medications, and switching to or enhancing treatment with psychotherapy.
Alan F. Schatzberg, M.D., from Stanford University School of Medicine, Stanford, Calif., and colleagues studied chronically depressed patients who were treated with either nefazodone (an antidepressant medication) or cognitive behavioral analysis system of psychotherapy (CBASP) for 12 weeks. Participants in the nefazodone group received an initial does of 200 mg per day (100 mg twice daily), which increased to a maximum of 600 mg per day. Those in the CBASP group attended sessions twice weekly during the first four weeks and then once weekly until week 12. If unresponsive to either the nefazodone or CBASP, patients were switched to the other treatment.