How effective are Fluoxetine, cognitive-behavioral therapy, or a combination of both in the treatment of depression in teenagers?
March JS, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, et al., on behalf of the TADS Team.
The Bottom Line:
Although both fluoxetine and CBT are effective in treating adolescents with major depression, a combination of the two was more effective in improving symptoms and reducing suicidal thinking. |
What problem is being addressed?
Teenagers with depression are treated with either SSRIs such as fluoxetine, or with Cognitive Behavioural Therapy (CBT). There has been little research showing whether one treatment is superior to the other, or if a combination of both would be the best approach.
What intervention is being tested?
This study used four different groups to study which is likely the best treatment for adolescent depression. 439 12- to 17-year olds diagnosed with major depression were randomly assigned to receive 10 to 40 mg of fluoxetine per day, CBT alone, CBT and fluoxetine together, or a placebo pill that resembled the fluoxetine.
What is the real scientific evidence?
The participants were tested with the Children’s Depression Rating Scale-Revised and the Clinical Global Impressions improvement score. The findings on these tests showed that fluoxetine alone was better than CBT alone, but the best improvement was seen with fluoxetine and CBT combined. 29% of the participants had suicidal thoughts when they entered the trial and 1.6% of the entire patient group attempted suicide. There were no deaths. The combination therapy was superior in reducing suicidal thinking.
The preceding is a summary of:
March JS, Silva S, Petrycki S, Curry J, Wells K, Fairbank J, et al., on behalf of the TADS Team. Fluoxetine, cognitive-behavioral theapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. Journal of the American Medical Association. 2004; 292(7): 807-820.
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