COGNITIVE THERAPY

Cognitive Therapy and Antidepressant Medications

Cognitive Therapy and Antidepressant Medications

A new study suggests that adolescents who are depressed may benefit most from a combination of cognitive behavioral therapy and an antidepressant medication such as Prozac (an SSRI or selective serotonin reuptake inhibitor). This combination approach is effective in reducing depressive symptoms as well as decreasing suicidal ideation (thoughts) and suicide attempts (March, 2007).

In one of the research study, 327 adolescents ages 12-17 with moderate to severe major depression were randomly assigned to one of three groups: medication only (Prozac), cognitive behavioral therapy (CBT) only, or a combination of both. After 18 weeks, 85% of the participants receiving combination therapy were "much" or "very much" improved (compared to 69% of adolescents who took Prozac only, and 65% who received CBT only) (March, 2007).

Symptom reduction benefits with combination therapy remained high across time. At 36 weeks, 86% of the teens receiving combination therapy were continuing to show improvement (while 81% of the Prozac-only and 81% of the CBT-only group experienced improvements).

Also interesting were the study's findings that participants' levels of suicidal thoughts and suicide attempts were significantly more common in the group receiving Prozac only when compared to the other groups. Only 2.5% of the adolescents receiving combination therapy reported suicidal thinking. In contrast, 13.7% of the participants in the Prozac only group experienced this type of thinking. There have been a number of recent media reports about the increased potential for suicidal thoughts and behaviors in children and adolescents who take SSRIs (Lint, 2011).

SSRI medications like Prozac work to prevent to the reabsorption of serotonin (a chemical messenger used throughout the brain and central nervous system) by neurons (cells in the brain and central nervous system). Research suggests that low levels of serotonin can contribute to a depressed mood. Preventing reabsorption (called ...