Magazine article Clinical Psychiatry News

Fluoxetine Plus CBT Best for Depressed Teens

Magazine article Clinical Psychiatry News

Fluoxetine Plus CBT Best for Depressed Teens

Article excerpt

Depressed adolescents respond best to a combination of fluoxetine and cognitive-behavioral therapy, said Dr. John S. March of Duke University, Durham, N.C., and his colleagues on the Treatment for Adolescents with Depression Study.

In a randomized, controlled study with four treatment arms, adolescents receiving fluoxetine alone did almost as well as those receiving both fluoxetine and cognitive-behavioral therapy (CBT). Both groups did significantly better than those receiving either CBT alone or placebo alone, the investigators reported (JAMA 292[7]:807-20, 2004).

The multicenter, 12-week TADS study involved 439 adolescents, aged 12-17 years, with a primary diagnosis of major depressive disorder (MDD) as defined by DSM-I. The adolescents, who entered the study between spring 2000 and summer 2003, were recruited from clinics, paid advertisements, primary care physicians, mental health clinicians, and schools and juvenile justice facilities.

The mean age of the participants was 14.6 years; 73.8% were white; 12.5% black; and 8.9% Hispanic. About 46% of the participants were male. They were randomized into one of the four treatment groups. Independent raters blinded to the patients' group assignments assessed symptoms at baseline, week 6, and week 12.

As measured by Clinical Global Impressions scores, 71% of the patients in the fluoxetine plus CBT group were judged to be much improved or very much improved. This compares with 61% for fluoxetine alone, 43% for CBT alone, and 35% for placebo.

On this measure, both fluoxetine and fluoxetine plus CBT were significantly superior to CBT alone and to placebo. …

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