Cognitive therapy works as well as antidepressants, but with lasting effect after th...( PHILADELPHIA Cognitive therapy to trea...),Health

PHILADELPHIA Cognitive therapy to treat moderate to severe depression works just as well as antidepressants, according to an authoritative report appearing today in the Archives of General Psychiatry. The study, conducted by researchers at the University of Pennsylvania and Vanderbilt University, challenges the American Psychiatric Association's guidelines that antidepressant medications are the only effective treatment for moderately to severely depressed patients.

Either form of treatment worked significantly better than a placebo, but the researchers demonstrated that cognitive therapy was more effective than medication at preventing relapses after the end of treatment.

"We believe that cognitive therapy might have more lasting effects because it equips patients with the tools they need to learn how to manage their problems and emotions," said Robert DeRubeis, professor and chair of Penn's Department of Psychology. "Pharmaceuticals, while effective, offer no long term cure for the symptoms of depression. For many people, cognitive therapy might prove to be the preferred form of treatment."

The study, which follows years of debate on the relative merits of cognitive therapy versus medication for more severe forms of depression, is the largest trial yet undertaken on the topic; it involved 240 depressed patients. The patients were randomly placed into groups that received cognitive therapy, antidepressant medication or a placebo. Patients in the antidepressant group, which was twice as large as the other two, were treated with paroxetine (Paxil). Lithium or desipramine was also given, as necessary.

After 16 weeks of treatment, patients in both the medication and cognitive therapy groups showed improvement at about the same rate; however, cognitive therapy patients were less likely to relapse in the two years following the end of treatment. According to the researchers, the return of symptoms might demonstrate that the medication
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Contact: Greg Lester
glester@pobox.upenn.edu
215 573-6604
University of Pennsylvania
4-Apr-2005

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