Combining Medication With Therapy Is a Reliable Way To Treat Severe Depression

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YIn the search for new treatments that can faithfully manage depression, it appears we have overlooked the power of one of the most standard treatment forms available today. According to new research, the combination of cognitive therapy with medication improves the odds of recovering from severe, nonchronic depression by as much as 30 percent. However, the benefits don’t hold true for those with chronic or less-severe depression.

“Our results indicate that combining cognitive therapy with antidepressant medicine can make a much bigger difference than we had thought to about one-third of patients suffering from major depressive disorder,” says Steven Hollon, professor of psychology at Vanderbilt University.

“On the other hand, it does not appear to provide any additional benefit for the other two-thirds.”

The latest research has shown that about two-thirds of all patients with major depressive disorder will improve when prescribed antidepressant medications and about one-third of patients will achieve full remission, but as much as half of those relapse before reaching full recovery.

In comparison to medication, cognitive therapy is similarly effective and its effects tend to last longer. When combined, the two have been estimated to improve recovery rates by up to 33 percent.

“Now, we have to reconsider our general rule of thumb that combining the two treatments keeps the benefits of both,” Hollon says.

The new study, published in JAMA Psychiatry, was a randomized clinical trial evaluating 452 adult outpatients with chronic or recurrent major depressive disorder. The majority of previous studies relied on a set time period for following subjects, but this team decided to follow treatment as long as it took. They followed patients through remission (full normalization of symptoms), all the way to recovery (six months without relapse).

“This provided us with enough data so that we could drill down and see how the combined treatment was working for patients with different types and severity of depression: chronic, recurrent, severe, and moderate,” Hollon says.

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