CBT may help reduce depression in people who have not responded to antidepressants

Published on December 7, 2012 at 10:08 AM · No Comments

For the first time in a large-scale randomised trial, scientists have demonstrated that people with depression who have not responded to treatment with antidepressants are three times more likely to get better if they receive cognitive behavioural therapy (CBT) in addition to antidepressants and usual care. The findings, published Online First in The Lancet, are good news for the two-thirds of people with depression who do not respond fully to initial treatment with an antidepressant.

“Until now, there was little evidence to help clinicians choose the best next step treatment for those patients whose symptoms do not respond to standard drug treatments”, says Nicola Wiles from the University of Bristol who led the research.

Wiles and colleagues recruited 469 adults (aged 18–75 years) who had not responded to at least 6 weeks of treatment with an antidepressant from 73 general practices across the UK. Participants were randomised to either continue with usual care provided by their general practitioner, which included continuing on antidepressant medication (235 patients), or to receive CBT in addition to usual care (234 patients)  and were followed up for 12 months.

After 6 months, 46% of participants who received CBT in addition to usual care had improved (reporting at least a 50% reduction in depressive symptoms) compared to 22% of those who continued with treatment as usual. Individuals in the intervention group were also more likely to experience remission and have fewer symptoms of anxiety. Similar beneficial effects were reported at 12 months.

In the UK, approximately 3% of adults report depression in the previous week, while every year in the USA about 7% of adults suffer from this debilitating condition. Depression is predicted to become the leading cause of disability in high income countries by 2030.

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