Aug 18 2004
Teenagers diagnosed with depression improved more with a combination of an antidepressant and cognitive-behavior therapy than they did when treated with either separately, according to a multicenter study published in the Journal of the American Medical Association. The study also found that depressed teens treated only with cognitive-behavior therapy did little better than teens given placebos.
The study is reportedly the first to directly compare psychotherapy and medication treatment for teenagers. It was conducted at 13 centers around the country and examined the effectiveness of four treatments for adolescents with major depressive disorder: treatment with fluoxetine (Prozac), treatment with cognitive-behavior therapy only, treatment with a combination of the two, and use of a placebo. The study included 439 patients ages 12 through 17.
Antidepressants are controversial when used to treat depression in children and adolescents. Since the results of this study were released, a number of experts have recommended that psychotherapy should be the first line treatment in this age group, with antidepressants reserved for adolescents who don't respond.
This particular study found a 71 percent improvement in teens receiving Prozac and therapy together, as compared with a 60 percent improvement rate in subjects given Prozac only, 43 percent for those in therapy only and 35 percent who took placebos.
Some experts believe that major depressive disorder affects 5 percent of American teens. Depression also contributes significantly to teen suicides and suicidal behavior, with suicide the third leading cause of death in adolescents.
There were no suicides in the TADS study. The number of suicide attempts was too small to analyze statistically, and there was little difference in the number of attempted suicides in each of the four groups examined.
Reference: Journal of the American Medical Association August, 2004
Last updated 11/5/05
