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Carefully Monitored Treatment Can Help Those Who Suffer from Depression

care” approach to delivering high-quality treatment for depression.

An important feature of the landmark clinical trial is that the 3,671 patients included were treated in “real-world” settings – 41 primary-care and psychiatric clinics around the country – rather than being nonpatient volunteers, as often is the case in such studies. In addition to suffering from major depression, most had other coexisting general medical and psychiatric conditions.

All participants initially received the same antidepressant medication. Those who didn’t experience remission or couldn’t tolerate the medication were strongly encouraged to proceed to the next step, where they were randomized to various groups receiving subsequent treatments including cognitive therapy alone or in combination with medication, as well as several different antidepressants used alone or in combination. Once patients achieved remission or made substantial improvement, they were followed closely for another 12 months.

“This report provides a summary of all the steps and a comprehensive view of outcomes from the largest depression trial ever conducted,” said Dr. Madhukar Trivedi, co-author of the study and professor of psychiatry at UT Southwestern. “It offers clear evidence of what happens step-by-step and gives us a good idea of what outcomes will be the following year, if patients continue the same treatment.”

Each year, about 21 million American adults – or 9.5 percent of the population – struggle with depression, often a recurring or chronic disorder. Depression frequently returns two or more times, with some episodes lasting two years or more.

“Depression is a disabling medical condition just like any other medical condition such as diabetes or congestive heart failure,” Dr. Rush said. “The take-home message for patients is to hang in there and stay in treatment, even if several steps and various medications must be tried. Be patient and willin
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