Sunday, March 23, 2008

Seriously Depressed Teens Respond to Combined Therapy

"If at first..." Many high-risk teenagers with depression show improvement on treatment combining medication with cognitive-behavioral therapy.

Over half of adolescents who don't respond to a first antidepressant improve when switched to a combination of a different antidepressant and cognitive-behavioral therapy (CBT). This is a key finding of an NIMH-funded clinical trial, the Treatment of SSRI-Resistant Depression in Adolescents (TORDIA).

Previous trials have shown that SSRI antidepressants or CBT or the combination can produce an adequate clinical response in up to 60 percent of treated adolescents, the authors noted, but, "There are no empirical studies to guide clinicians regarding the management of adolescents with depression not responsive to an initial treatment with an SSRI."

Previously, the Treatment of Adolescent Depression Study (TADS) demonstrated a similar benefit for combined therapy, but it tested a treatment-naïve group of depressed adolescents. TORDIA differed in two ways from TADS. It was aimed at youth who had not responded to a first round of treatment, and it included more chronically depressed adolescents (averaging two years) and more with suicidal ideation (59 percent)—groups often excluded from clinical trials, said lead author David Brent, M.D., in an interview with Psychiatric News.

READ MORE @ PSYCHIATRIC NEWS