Rx Vs. Therapy: Which Works Best for Depression?

Cognitive behavioral therapy, second-generation antidepressants may be equally effective for severe depression

/ Author:  / Reviewed by: Jennifer Gershman, PharmD, CPh

(RxWiki News) Taking antidepressants for depression? Going to therapy? Either way, you're probably getting a similar outcome.

A new study found that second-generation antidepressant medications and cognitive behavioral therapy (CBT) may be equally effective in the treatment of adults with major depressive disorder (MDD). In light of this finding, researchers said that both treatment options should be made easily accessible to all MDD patients.

CBT is a type of mental health counseling that can help patients become aware of inaccurate or negative thinking, so that they can respond to challenging situations in a more effective way.

MDD is the most common and disabling type of depression, affecting more than 32 million Americans. This disorder is marked by a persistent feeling of sadness and loss of interest severe enough to interfere with daily life. Treatment is typically started in the primary care setting with second-generation antidepressant drugs such as SSRIs.

For this study, a team of researchers led by Gerald Gartlehner, MPH, an epidemiologist at Danube University in Austria, looked at data from 11 other studies on the topic. Each study compared second-generation antidepressants to CBT for the initial treatment of MDD. A total of 1,511 patients with MDD were involved.

No significant differences in the rates of response, remission or positive changes in depression score between the two treatments were found. Similarly, no differences were found in the rates of overall study discontinuation or discontinuation due to lack of treatment effectiveness.

In an editorial about this study, Mark Sinyor, MD, a psychiatrist at the University of Toronto, and colleagues, noted that evidence is still limited.

"Ultimately, the results of this analysis should be simultaneously reassuring and disappointing for patients and their doctors," Dr. Sinyor and colleagues wrote. "Reassuring because if only one of these two treatments is available, affordable or preferred, choosing that option is unlikely to affect a patient’s chances of improvement, remission or tolerance of treatment. Disappointing because there is such a limited reliable evidence base to evaluate these basic treatments ..."

This study was published Dec. 8 in the journal The BMJ.

The Agency for Healthcare Research and Quality funded this research. No conflicts of interest were disclosed.

Review Date: 
December 9, 2015
Last Updated:
December 10, 2015