Tuesday, October 2, 2007

Drugs and behavior therapy help teens battling depression
by Kelly Winget, DCRI Communications

For teens who suffer from major depressive disorder, the best treatment involves a mix of antidepressants and cognitive behavior therapy, according to a new study led by the DCRI's John March, MD, chief of child and adolescent psychiatry at Duke University Medical Center.

March led the Treatment for Adolescents with Depression Study (TADS), which found that using anti-depressants in addition to therapy helped improve the symptoms of depression and reduce suicidal thinking and behavior in teens. The study results are published in the October issue of the Archives of General Psychiatry.

Cognitive behavior therapy attempts to change unhealthy thought and behavior patterns and replace them with positive patterns.

“Depression among teenagers is a significant public health problem and there has been a tremendous need to identify treatments that work and are also safe,” said March. “We found that the benefits of treatment with medication in combination with cognitive behavior therapy (CBT) outweighed the potential risks.”

TADS is a multicenter, randomized trial evaluating the effectiveness of the antidepressant Prozac and CBT by themselves and as a combined treatment in teens diagnosed with depression. Researchers found that Prozac plus therapy was more effective than medication alone over the course of 36 weeks. The study was funded by the National Institute of Mental Health (NIMH).

The study included 327 patients between the ages of 12 and 17 with a primary diagnosis of major depressive disorder.

All of the patients experienced a decrease in their depression after 12 weeks, but the teens receiving the drug and the therapy saw the greatest difference. Halfway through the study, the teens receiving the combination treatment were reporting more significant improvements in how they felt then their peers receiving either Prozac or only cognitive behavior therapy.

Many of the teens in the study reported suicidal thoughts at the beginning of the study, but researchers found that patients only treated with Prozac had higher rates of suicidal thinking and behaviors than teens who received either CBT or the combined therapy. Researchers believe Prozac helps teens recover from the symptoms of their depression, but that CBT gives the teens the coping skills that they need.