Adjunctive psychotherapy added to antidepressant medications for patients with chronic depression did not increase the proportion of patients achieving remission, according to a study in the November issue of the Archives of General Psychiatry.
James H. Kocsis, M.D., of Weill Cornell Medical College in New York City, and colleagues treated chronically depressed patients using a two-phase treatment protocol with phase one consisting of an antidepressant medication used in accordance with a pharmacotherapy algorithm. After phase one, patients not achieving remission were randomized to 12 weeks of either continued medication and the addition of the cognitive behavioral analysis system of psychotherapy, continued medication and the addition of brief supportive psychotherapy, or optimized medication alone.
READ MORE @ MODERN MEDICINE
Showing posts with label CHRONIC DEPRESSION. Show all posts
Showing posts with label CHRONIC DEPRESSION. Show all posts
Tuesday, November 10, 2009
Sunday, November 8, 2009
Chronically Depressed? What to Do When Antidepressants Don't Work
The range of options includes cognitive behavioral therapy and brain stimulation techniques like ECT.
Last winter, confined to bed by intense sadness, exhaustion, and headaches, the University of Kansas student found herself considering suicide. Desperate after a years-long struggle with depression, she sought a treatment she had once viewed as extreme: electroconvulsive therapy. After a few sessions, "I literally went from almost unable to function—feeling suicidal—to a 180-degree change," she says.
The student, who still contends with depression, is one of the many people chronically in its grip who, disappointed by antidepressants, are finding some relief in therapies ranging from exercise to various forms of high-tech brain stimulation. Some 27 million Americans were taking an antidepressant in 2005, more than twice the number almost 10 years earlier, thanks largely to the arrival of Prozac and other effective antidepressants with fewer side effects. But a groundbreaking 2006 trial known as STAR*D revealed that about one third of people found total relief with their first drug, and around a third were not helped even after trying several drugs and combinations. ECT, which has been controversial since the days when it was performed without anesthesia and sometimes without proper consent, has evolved considerably in recent years; by inducing a seizure, it is thought to reset dysfunctional brain circuitry. It "is the most effective and rapidly acting treatment for severe depression," says Sarah Lisanby, a professor of clinical psychiatry at Columbia University Medical Center who is a leading brain stimulation researcher.
READ MORE @ U.S. NEWS & WORLD REPORT
Last winter, confined to bed by intense sadness, exhaustion, and headaches, the University of Kansas student found herself considering suicide. Desperate after a years-long struggle with depression, she sought a treatment she had once viewed as extreme: electroconvulsive therapy. After a few sessions, "I literally went from almost unable to function—feeling suicidal—to a 180-degree change," she says.
The student, who still contends with depression, is one of the many people chronically in its grip who, disappointed by antidepressants, are finding some relief in therapies ranging from exercise to various forms of high-tech brain stimulation. Some 27 million Americans were taking an antidepressant in 2005, more than twice the number almost 10 years earlier, thanks largely to the arrival of Prozac and other effective antidepressants with fewer side effects. But a groundbreaking 2006 trial known as STAR*D revealed that about one third of people found total relief with their first drug, and around a third were not helped even after trying several drugs and combinations. ECT, which has been controversial since the days when it was performed without anesthesia and sometimes without proper consent, has evolved considerably in recent years; by inducing a seizure, it is thought to reset dysfunctional brain circuitry. It "is the most effective and rapidly acting treatment for severe depression," says Sarah Lisanby, a professor of clinical psychiatry at Columbia University Medical Center who is a leading brain stimulation researcher.
READ MORE @ U.S. NEWS & WORLD REPORT
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