A combination of cognitive-behavioral therapy along with medication enhances treatment for children and adolescents suffering from depression.
In a new clinical trial, investigators discovered depression relapse rates were substantially lower in a group of youths who received both forms of treatment versus medication alone.
“Continuation-phase strategies designed to reduce the high rates of relapse in depressed youths have important public health implications, as recurrence of depression is more likely in youths with multiple episodes,” said Dr. Betsy Kennard, senior author and professor of psychiatry at University of Texas Southwestern Medical Center in Dallas, Texas.
The study has been published in The American Journal of Psychiatry.
Sadly, the typical relapse rates in youth with major depressive disorders typically ranges from 40 percent to 70 percent.
Yet the relapse rate for the study of 75 youth who received behavioral therapy for six months following six weeks of initial treatment with the antidepressant fluoxetine, also known as Prozac, was nine percent.
Among the group of 69 youth who received only the drug during this period, 26.5 percent relapsed.
Youth who showed improvement after receiving fluoxetine for an initial six-week treatment period continued in the study, split between the medication-only and therapy plus medication groups. Study participants’ ages ranged from eight to 17.
“Unfortunately, medication alone is not always enough to prevent relapse,” said Dr. Graham Emslie, a contributing author of the study.
“Identifying novel strategies to prevent future relapses for young people should be a priority. This approach is unique in that treatment was added at a time when the intensity of care is frequently decreasing.”
The type of therapy used in this trial — called Relapse Prevention Cognitive Behavioral Therapy — is an individual psychotherapy treatment with a family component that focuses on reducing residual symptoms, increasing wellness behaviors, and preventing relapse.
For six months, the young people in this arm of the trial participated in eight to 11 therapy sessions that were tailored to each child.
“It is also worth noting that youth who received the therapy had lower medication doses, yet had better outcomes than those on higher dosages in the medication management-only group,” said Kennard.