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Cognitive behavioural therapy and medication change helps depressed adolescents

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Adolescents are more likely to show a clinical response to antidepressants if they switch medication and undergo cognitive behavioural therapy (CBT), a study has shown.

Researchers conducted a trial using a sample of 334 patients aged 12 to 18 years with a primary diagnosis of a major depressive disorders over a 12 week period.

Antidepressants used were all selective serotonin reuptake inhibitors (SSRIs), which were shown in a study published last week to be little better than placebos.

Subjects were randomly selected to one of groups. The first group were selected to receive venlafaxine alone, the second received venlafaxine with CBT, the third received a change of SSRI alone and fourth were received to change a change of SSRIs with CBT.

Other SSRIs featured in the study were fluoxetine, paroxetine and citalopram.

Results showed CBT plus a change of medication showed a response rate of 54.8% as measured on the Children’s Depression Rating Scale – Revised.

A medication switch alone showed a response rate of 40.5% and there was little difference between patients in the venlafaxine group and those switching to other antidepressants.

Authors wrote: ‘Switching to a combination of CBT and another antidepressant resulted in a higher rate of clinical response than switching to another medication without CBT.’

Journal of the American Medical Association (2008) 299:901-913

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