Young people seeking help for depression should be offered psychotherapy as the first line of treatment, and medication should be a secondary option, according to a clinical trial by researchers at Orygen, the National Centre of Excellence in Youth Mental Health in Australia.
The findings, published in The Lancet Psychiatry journal, show that patients (ages 15 to 25) who received psychotherapy alone did just as well as those who received both psychotherapy and an antidepressant medication. However, the researchers found some evidence suggesting that if antidepressants do play a role, it would be in those at the older end of that age range.
“The results suggest that we should really be focusing on providing good quality psychotherapy, such as cognitive behavioral therapy, to young people and keeping medication as the second line of treatment,” said Associate Professor Christopher Davey, head of mood disorder research at Orygen.
Psychotherapy refers to a range of psychological therapies given by a counselor, psychologist or psychiatrist. Cognitive behavioral therapy is often recommended for treating depression in young people.
The randomized, double blind, placebo-controlled clinical trial involved 153 young people, ages 15 to 25, who had been diagnosed with depression and were being treated at youth mental health services in north-west Melbourne, Australia.
All trial participants received cognitive behavioral therapy for 12 weeks coupled with either the common antidepressant fluoxetine (Prozac) or a placebo medication.
According to the findings, there were no significant differences in symptom improvement between the two groups, suggesting that the addition of fluoxetine did not affect the participants’ mental health outcomes.
However, this does not suggest that antidepressants should not be used in treating depression.
“Antidepressants can be very useful for some people,” Davey said. “Anyone considering the role of antidepressants in their treatment should discuss this with their doctor or clinician.”
“Our study found some evidence to suggest that if antidepressants have a role, they have more of a role in people at the older end of our age range.”
Depression affects around 20 percent of teens by the time they become adults. Symptoms of depression in young people may include withdrawing from school and activities, feelings of sadness or hopelessness, anger, overreaction to criticism, poor self-esteem, guilt, and many others.
Overall, the research highlights the importance of a multi-faceted approach to treating depression in young people.
“The take-home message from the study is that the first-line treatment for young people with depression should be psychotherapy,” said Davey.