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When Antidepressants Don't Work, Give Counseling a Try
Date:12/7/2012

>To test the value of cognitive behavioral therapy, Wiles' team randomly assigned more than 400 people who suffered from depression and who had not responded to six weeks of antidepressant therapy to continue their medications, some while receiving cognitive behavioral therapy and others not.

After six months, the researchers found that 46 percent of those receiving cognitive behavioral therapy improved, compared with 22 percent of those on antidepressants alone.

Improvement was pegged at a minimum 50 percent reduction in depressive symptoms, the researchers noted.

People receiving cognitive behavioral therapy were also more likely to not have any symptoms of depression or anxiety. And the results held a year later, the researchers added.

In Britain, about 3 percent of adults report being depressed. In the United States, about 7 percent of adults suffer from depression, the researchers noted.

By 2030, depression is expected to be the leading cause on disability in high-income countries, they added.

"An inadequate treatment response to antidepressant medication is an all-too-frequent outcome for depressed patients," said Michael Otto, a professor of psychology at Boston University and co-author of an accompanying journal editorial.

This study addresses this issue by showing that cognitive behavioral therapy is an useful next step for these patients, he said.

"Patients have a choice about treatment, either when initiating care or when trying to improve treatment response if the first option does not work," Otto said. "Cognitive behavioral therapy should figure highly in these treatment choices."

Simon Rego, director of psychology training at Montefiore Medical Center/Albert Einstein College of Medicine in New York City, said "there is a great deal of evidence that supports cognitive behavioral therapy as a first-line treatment for depression, it is often also suggested as a next-step treatment option for patients
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