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Description: If your physician told you that he or she thought you might be depressed and indicated that they could either provide you with antidepressant drugs or refer you for cognitive behaviour therapy which would you pick? Before answering have a look at this article and consider the research it discusses.

Source: Talking Therapy as Effective as Antidepressants, Study Finds: Health News from NHS Choices

Date: December 10, 2015

CBT and Drugs

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Links: Article Link —

There are a variety of medical opinions out there about the optimal course of treatment for a patient showing clear DSM symptoms of depression. Some physicians believe that antidepressants are the optimal choice while others believe that patients ought to start on antidepressants and then take up some form of talking therapy once the antidepressants start to show positive effect. Other physicians argue that a combination of antidepressants and psychotherapy is to be preferred. The answer to which approach is preferred really needs to be decided on the basis of data and not on the basis of a single study. The study reviewed in this article was a meta-analytic study. This means that the authors of this research gathered together the results of a number of studies (in this case 11 studies) and pooled their results to provide a much clearer indication of how CBT or cognitive behaviour therapy impacts the symptoms of depression as compared to the current array of antidepressants such as selective serotonin reuptake inhibitors. The bottom line was that based on data from over 1500 patients neither of these treatment showed a clear advantage over the other or in other words both drugs or cognitive behaviour therapy are equally effective in treating the symptoms of moderate to severe clinical depression. The article and the media report about it briefly discuss the implications of this finding for the medical treatment of individuals struggling with symptoms of depression. Read through the review article and perhaps have a look at the research article itself which is available through the link under additional reading below and then think about what your own decision might be if you are offered a choice between these two forms of treatment.

Questions for Discussion:

  1. How did CBT fare has a treatment for depression compared to antidepressant drugs?
  2. Given that these two treatments produce similar results what sorts of additional factors ought to be considered when deciding which treatment route to follow?
  3. What additional research is needed if we wish to make general medical policy and treatment statements about the treatment of individuals presenting with symptoms of moderate to severe depression?

References (Read Further):

Halle R Amick, Gerald Gartlehner, Bradley N Gaynes, Catherine Forneris, Gary N Asher, Laura C Morgan, Emmanuel Coker-Schwimmer, Erin Boland, Linda J Lux, Susan Gaylord, Carla Bann, Christiane Barbara Pierl, Kathleen N Lohr. (2015) Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis. BMJ, 351, h6019

Weitz, E. S., Hollon, S. D., Twisk, J., van Straten, A., Huibers, M. J., David, D., … & Faramarzi, M. (2015). Baseline depression severity as moderator of depression outcomes between cognitive behavioral therapy vs pharmacotherapy: an individual patient data meta-analysis. JAMA psychiatry, 72(11), 1102-1109.