Psychotherapy most effective as treatment for depression in youth

A new study, conducted at Orygen, the National Centre of Excellence in Youth Mental Health, found psychotherapy more effective as a first-line treatment for depression in young people than antidepressants, or other psychotropic treatments.

Researchers recruited 153 patients aged 15-25 diagnosed with moderate-to-severe major depressive disorder as part of a randomized, double-blind, placebo-controlled, multicentre clinical trial. Participants were randomly assigned to undergo cognitive behavioral therapy (CBT) for 12 weeks. They were also administered either fluoxetine, a selective serotonin reuptake inhibitor (SSRI) antidepressant, or a placebo, along with CBT.

By the end of treatment, researchers found no drastic changes in symptom improvement between both groups, concluding that psychotherapy in conjunction with fluoxetine did not show significant benefits.

“The results suggest that we should really be focusing on providing good quality psychotherapy, such as cognitive behavioural therapy, to young people and keeping medication as the second line of treatment,” said Christopher Davey, a researcher and associate professor at Orygen.

“We did not find evidence that the addition of fluoxetine (rather than placebo) to CBT further reduced depressive symptoms in young people with moderate-to-severe MDD. Exploratory analyses showed that the addition of medication might be helpful for patients with comorbid anxiety symptoms and for older youth.”

The findings, researchers say, does not by any means derail the importance of antidepressants or its beneficiary uses for treating symptoms of depression. “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,” Davey stated.

“Antidepressants can be very useful for some people. Anyone considering the role of antidepressants in their treatment should discuss this with their doctor or clinician.”