New study reveled - Cognitive therapy more effective than medication

Cognitive therapy to treat moderate to severe depression works just as well as antidepressants. The research, funded by a $4 million grant from the National Institutes of Health, was published in the Archives of General Psychiatry.

Cognitive therapy is a type of talk therapy that involves changing a person’s negative thought patterns.

The study, conducted by researchers at the University of Pennsylvania and Vanderbilt University, challenges the American Psychiatric Association’s guidelines that antidepressant medications are the only effective treatment for moderately to severely depressed patients.

The study by the University of Pennsylvania and Vanderbilt University

The researchers demonstrated that cognitive therapy was more effective than medication at preventing relapses after the end of treatment.

“We believe that cognitive therapy might have more lasting effects because it equips patients with the tools they need to learn how to manage their problems and emotions,” said Robert DeRubeis, professor and chair of Penn’s Department of Psychology. “Pharmaceuticals, while effective, offer no long term cure for the symptoms of depression. For many people, cognitive therapy might prove to be the preferred form of treatment.”

The study, which follows years of debate on the relative merits of cognitive therapy versus medication for more severe forms of depression, is the largest trial yet undertaken on the topic; it involved 240 depressed patients. The patients were randomly placed into groups that received cognitive therapy, antidepressant medication or a placebo. Patients in the antidepressant group, which was twice as large as the other two, were treated with paroxetine (Paxil). Lithium or desipramine was also given, as necessary.

After 16 weeks of treatment, patients in both the medication and cognitive therapy groups showed improvement at about the same rate; however, cognitive therapy patients were less likely to relapse in the two years following the end of treatment. According to the researchers, the return of symptoms might demonstrate that the medication may have blunted the appearance of depression but did not affect underlying disease processes.

“Medication is often an appropriate treatment, but drugs have drawbacks, such as side effects or a diminished efficacy over time,” DeRubeis said. “Patients with depression are often overwhelmed by other factors in their life that pills simply cannot solve. In many cases, cognitive therapy succeeds because it teaches the skills that help people cope.”

Robert DeRubeis, a University of Pennsylvania psychologist and study co-author, says the results show cognitive therapy has a lasting effect while depression medication only helps as long as it’s being taken.

The authors of the study believe that these results directly challenge the American Psychiatric Association’s guidelines for treating patients of depression, which states that most people suffering from moderate to severe depression will require medication.