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‘No difference’ in efficacy between some drugs and CBT

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There is no difference in the treatment effects of second generation antidepressants and cognitive behavioural therapy for patients with major depressive disorder, according to a study.

Given people may have a personal preference, researchers said both treatments should be made accessible, either alone or in combination, to patients with major depressive disorder.

“Both treatments should be made accessible, either alone or in combination, to primary care patients with major depressive disorder”

Study authors

They said some previous research suggested patients might prefer treatment with psychotherapy over medication, for example with selective serotonin reuptake inhibitors, but evidence about which was most effective was unclear.

The study, including researchers from Danube University in Austria and the University of North Carolina in the US, analysed the results of 11 trials, involving a total of 1,511 patients.

Each trial compared second generation antidepressants and CBT for the initial treatment of major depressive disorder.

Differences in study design and quality were taken into account to minimise bias, said the authors in the British Medical Journal.

The team said they found no statistically significant difference in effectiveness between second generation antidepressants and CBT for response, remission, or change in depression score.

Similarly, no significant differences were found in rates of overall study discontinuation or discontinuation due to lack of effectiveness.

The researchers said their results “should be interpreted cautiously, given the low strength of evidence for most outcomes”, but that they were “relatively consistent with similar meta-analyses”.

They recommended that both treatments “should be made accessible, either alone or in combination, to primary care patients with major depressive disorder”.

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