Cognitive Therapy Versus Antidepressants for More Severe Depressions

Cognitive therapy (CT) and antidepressants are considered equally effective for all but severe forms of depression, for which antidepressants are preferred. In this study, researchers . . .

Cognitive therapy (CT) and antidepressants are considered equally effective for all but severe forms of depression, for which antidepressants are preferred. In this study, researchers randomized 240 patients with severe depression (mean Hamilton Depression Rating Scale [HDRS] score, 23) to receive CT by well-trained therapists for 16 weeks, paroxetine (mean dose, 39 mg) for 8 weeks, or pill placebo for 8 weeks. Seventy-two percent had at least one Axis I disorder, and about 48% had at least one Axis II disorder.

At 8 weeks, antidepressant and CT had response rates (HDRS ≤12) of 50% and 43%, respectively, which were equivalent to each other and superior to placebo (25%), and had similar effect sizes (0.60 and 0.44, respectively). After 8 week…

Reviewing Author

Steven Dubovsky, MD