A combination of psychotherapy and antidepressant medication appears to be the most effective treatment for adolescents with major depressive disorder - more than medication alone or psychotherapy alone, according to results from a major clinical trial funded by the National Institutes of Health's National Institute of Mental Health (NIMH).
The study was published in the October 2007 issue of the Archives of General Psychiatry.
The long-term results of the Treatment for Adolescents with Depression Study (TADS) found that when adolescents received fluoxetine (Prozac) alone or in combination with cognitive behavioral therapy (CBT) over the course of 36 weeks, they recovered faster than those who were receiving CBT alone.
However, taking fluoxetine alone appeared to pose some safety concerns for the teens. During treatment, those taking fluoxetine alone had higher rates of suicidal thinking (15 percent) than those in combination treatment (8 percent) and those in CBT alone (6 percent), particularly in the early stages of treatment. This suggests that while treatment with fluoxetine may speed recovery, adding CBT provides additional safeguards for those vulnerable to suicide, according to the researchers.
“Depression in teens is a serious illness that can and should be treated aggressively,” said NIMH Director Thomas R. Insel, M.D. “TADS provides compelling evidence for families and clinicians that the most effective way to treat depression in teens is with a two-pronged approach. It reassures us that antidepressant medication combined with psychotherapy is an effective and safe way to help teens recover from this disabling illness.”