Navigation Links
Antidepressants do work in depression while evidence for CBT is poorer say experts
Date:5/6/2008

Los Angeles, London, New Delhi, and Singapore (6 May, 2008) A new revision of clinical guidelines to help doctors manage patients with depression has challenged the rationale behind the UK governments policy of rolling out of cognitive behavioural therapy (CBT) for milder depression.

According to a comprehensive review of treatments for depression, there is a lack of evidence for CBT being more helpful than other forms of psychological support in mild depression or for its efficacy in severe depression. There is also good evidence for antidepressants being effective in depression, with benefit increasing the more severe the depression. This is contrary to recent reports that antidepressants dont work except in the most severe depression.

Dr Ian Anderson, Senior Lecturer and Honorary Consultant Psychiatrist, Neuroscience and Psychiatry Unit, University of Manchester, UK, says the cost effectiveness of CBT should be thoroughly investigated before it is adopted more widely because it is likely to be offered to people with milder depression where the evidence is poorest.

There is often not a level playing field in considering evidence for drugs versus psychological treatment, especially in milder depression, Dr Anderson explains, adding that specific psychological treatments are relatively expensive compared to drug treatments because treatment involves training of the therapists as well as the costs of administering the intervention.

To measure the effectiveness of these treatments requires comparison against appropriate control treatment like non-specific supportive treatment in the same way drugs are compared against placebo, says Dr Anderson. This is important given the rolling out of CBT for milder depression probably less expensive means of support are more cost-effective.

This conclusion is just one of the issues to emerge from a comprehensive review of the evidence for various forms of management of depression, conducted as part of a revision of the 2000 British Association for Psychopharmacology evidence-based guidelines, and published this week by SAGE in the Journal of Psychopharmacology. The aim of the review was to incorporate new evidence and to update the recommendations where appropriate.

Revisions to the guidelines were agreed after a consensus meeting involving experts in depressive disorders and their management, user representatives, and medical and scientific staff from pharmaceutical companies in May 2006 and a subsequent literature review.

The new guidelines also question whether CBT should routinely be combined with antidepressant medication for depression in adolescentsas the UKs National Institute for Health and Clinical Excellence suggestsciting a lack of evidence. Dr Anderson says some recommendations run contrary to NICE guidance:

  • First, the choice between antidepressants and CBT needs to be individually decided rather than routinely recommending CBT first.
  • Second, combining CBT with antidepressants should not be routine.

He suggests that doctors should try to adopt a more dimensional approach to depression rather than over-emphasising categories of disease severity such as not depressed, clinical depression, etc, or relying too heavily on cut-off points such as simply counting symptoms. It is important to consider an individual patients situation in a more rounded fashion such as past history, degree of impairment, duration of symptoms and risk of relapse.

Overall, the guidelines clear up some issues and alter the emphasis on certain treatments for example suggesting that for subthreshold depression, which is not of clinical severity, antidepressants should be considered if it lasts more than 2-3 months, Dr Anderson says. We have also challenged the idea that antidepressants need to be given more than once a day or that for most antidepressants you need to follow a long tailing off before starting a new antidepressant.

We hope [the guidelines] will set a standard. We have tried to be practical in our advice and addressed issues that other guidelines tend not to be specific about such as managing side-effects of antidepressants. We want to help doctors and patients choose treatments and strategies that have the best chance of helping, Dr Anderson concludes.


'/>"/>

Contact: Mithu Mukherjee
mithu.mukherjee@sagepub.co.uk
020-732-42223
SAGE Publications UK
Source:Eurekalert

Related medicine news :

1. A link between antidepressants and type 2 diabetes
2. FDA Warning of Suicidal Risk Associated with Antidepressants in Juveniles and Young Adults Reviewed at Recent ISCTM Meeting
3. Only Severely Depressed Benefit From Antidepressants: Study
4. As depression symptoms improve with antidepressants, hopelessness can linger
5. Antidepressants Can Increase Depression, Impulsivity and Suicide Risk by Decreasing Dopamine
6. Antidepressants that are more efficient and faster
7. Genetics May Determine Antidepressants Effectiveness
8. Antidepressants Help HIV-Infected Patients Stick to Treatment
9. Study shows new strategy for developing antidepressants
10. Antidepressants Boost GI Bleeding Risk
11. Antidepressants and painkillers - a dangerous combination
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/12/2017)... Bethesda, MD (PRWEB) , ... October 12, 2017 , ... ... Award of Excellence to Carol Friedman, PhD, FACMI, during the Opening Session of AMIA’s ... 4 – 8. , In honor of Morris F. Collen, a pioneer in the ...
(Date:10/12/2017)... Rockville, Maryland (PRWEB) , ... October 12, 2017 ... ... a magnetic drug delivery system that we intend to develop to enable prevention ... regimens can lead to severe hearing loss, especially in pediatric patients. For cisplatin, ...
(Date:10/12/2017)... ... October 12, 2017 , ... HMP , a leader in healthcare events ... Magazine Eddie Digital Award for ‘Best B-to-B Healthcare Website.’ Winners were announced during the ... The annual award competition recognizes editorial and design excellence across a range of sectors. ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... On Saturday, ... a treadmill relay – Miles by Moonlight to raise money for the American Heart ... or more. , Teams will work together to keep their treadmills moving for ...
(Date:10/12/2017)... ... October 12, 2017 , ... Health Literacy Innovations (HLI), ... software tool, and the Cancer Patient Education Network (CPEN), an independent professional organization ... a new strategic alliance. , As CPEN’s strategic partner, HLI will help ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... 2017 Diplomat Pharmacy, Inc. (NYSE: ... Consulting, LLC , and named its founder as Diplomat,s ... Tennessee , will operate under Diplomat ... service offerings for health care partners to include IT ... "In an interoperable world, technology delivers comprehensive ...
(Date:10/2/2017)... PHILADELPHIA , Oct. 2, 2017 Halo Labs announces ... particle analysis system called the HORIZON at MIBio 2017 in ... analyzes subvisible and visible particulate matter in biopharmaceutical samples with unprecedented ... use of the novel technique Backgrounded Membrane Imaging. ... The HORIZON subvisible particle analysis system ...
(Date:9/28/2017)... Sept. 28, 2017 Cohen Veterans Bioscience and ... use of wearable and home sensors for real-time monitoring ... Signal Foundation, a nonprofit organization focused on disruptive health ... an affordable analytical system to record and integrate behavioral, ... ...
Breaking Medicine Technology: