The Treatment for Adolescents with Depression Study (TADS).
Long-term effectiveness and safety outcomes
March JS on behalf of the TADS team
The Bottom Line:
Suicidal thoughts/attempts decrease with treatment. Although both drug therapy and CBT successfully treated moderate to severe depression in teenagers, a combination of the two therapies was superior to either of them alone in improving symptoms of depression and in decreasing the frequency of suicidal thoughts and attempts. |
What problem is being addressed?
Teenagers who are depressed are at high risk for suicide. The use of antidepressant drugs has declined, partly because of media reports on studies that showed an increased risk of suicide in teens on antidepressants. This has led to a reduction in their use.
What intervention is being tested?
This was a multicentre randomized controlled trial conducted in 13 sites in the US that tested the effectiveness of fluoxetine (Prozac®) vs. placebo, cognitive behavioural therapy (CBT), or both the medication and CBT together in treating depression.
What is the real scientific evidence?
327 teens aged 12 to 17, all with a diagnosis of major depression, took part in the study. The participants were tested at the beginning of the study with the Children’s Depression Rating Scale to determine the severity of their depression. Those with a depression described as either moderate or severe were admitted to the trial. Treatment response was defined as a score of much or very much improved on the Clinical Global Impressions test. By the end of the study, 73% of those who got combination therapy, 62% of those who got fluoxetine, and 48% who got CBT had good treatment response. By the end of follow up at 36 weeks 86% of the combination group, 81% of the fluoxetine and 81% of the CBT group had gotten better. Suicidal thoughts and attempts decreased with treatment; however, they were more common in the drug alone group compared to CBT alone.
The preceding is a summary of:
The Treatment for Adolescents with Depression Study (TADS). Long-term effectiveness and safety outcomes.
Archives of General Psychiatry. 2007; 64(10): 1132-1144.
^top
