Antidepressants, "Talk Therapy" Effective Therapy for Teen Depression

[Families Together in NYS]

Antidepressants, "Talk Therapy" Effective Therapy for Teen Depression

Newswise - A new study from the Johns Hopkins Children's Center and 12 other
medical centers shows the most effective treatment for adolescents with
major depressive disorder is a combination of antidepressants and
psychotherapy. Researchers say the study's findings indicate this
combination treatment may be best for both improving depression and reducing
the level of suicidal thinking in adolescents. 

The multicenter Treatment for Adolescents with Depression Study (TADS)
clinical trial, sponsored by the National Institute of Mental Health, is
believed to be the first to examine the individual and combined
effectiveness of the antidepressant fluoxetine (Prozac) and cognitive
behavioral ("talk") therapy in depressed adolescents. The findings are
published in the August 18th issue of the Journal of the American Medical
Association.

Overall, combined antidepressant and talk therapy treatment yielded the best
results, followed by antidepressants alone. However, talk therapy on its own
was found to be no more effective than placebo, the researchers say.

"Until this study, there was limited evidence that proved antidepressants
were appropriate for use in teenagers with depression," says John Walkup,
M.D., a co-author of the study and a child and adolescent psychiatrist at
the Johns Hopkins Children's Center. "Not only do the results support the
use of antidepressants for depressed teens, but when used in conjunction
with talk therapy, these medications actually provide teens with the best
chance to alleviate their depression." 

Controversy has surrounded the use of Prozac and similar medications (known
as selective serotonin reuptake inhibitors) because of reports that they may
lead a small number of teenagers and children to become suicidal. In the
current study, researchers found that the level of suicidal thoughts, which
had been present in 29 percent of the youths at the beginning of the study,
decreased significantly regardless of the treatment received, with the
combination of fluoxetine and talk therapy showing the greatest reduction.
While no patients committed suicide during the study, there were seven cases
of attempted suicide during the treatment phase of the study. 

However, Walkup says the development of new suicidal thoughts after starting
antidepressant medication is unusual. "As long as youths taking
antidepressants are monitored closely by their physicians, I believe the
benefits of antidepressants for depressed teens really outweigh the risks.
Antidepressants can be a safe and effective treatment for teens with
depression, a common condition that can be devastating if left untreated,"
he says.

During the first 12-week section of the study, 439 youths ages 12 to 17 with
moderate to severe depression were randomly assigned to a treatment of
either fluoxetine; cognitive behavior therapy, during which a therapist
reinforces positive thought patterns and behavior; a combination of
fluoxetine and talk therapy; or placebo pills. 

Using common psychological scales to measure depression severity,
researchers found that 71 percent of teens who received fluoxetine and talk
therapy improved with treatment, compared with 60.6 percent who received
fluoxetine alone, 43.2 percent who received talk therapy alone, and 34.8
percent who received a placebo treatment. 

After 12 weeks, patients who were receiving fluoxetine, talk therapy, or a
combination of both continued treatment for two more stages, while those who
had not responded to placebos were offered the "active" treatment of their
choice. However, results to date include only the first 12 weeks of
treatment. 

The study was led by John S. March, M.D., M.P.H., from Duke University
Medical Center. Other TADS sites include: Johns Hopkins Children's Center,
Carolinas Medical Center, Case Western Reserve University, Children's
Hospital of Philadelphia, Columbia University, University of Nebraska, New
York University, University of Chicago and Northwestern University,
Cincinnati Children's Hospital Medical Center, University of Oregon,
University of Texas Southwestern and Wayne State University. 

For more information about the Johns Hopkins Children's Center, please
visit: www.hopkinschildrens.org

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