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Antidepressants or psychotherapy for depression? Psychotherapy works better.

OK, now I'm ticked. Last week there was all this ballyhoo about how antidepressants help with depression according to a study done by NIH.

Well, even though the pharmaceutical companies are overjoyed, the fact is that psychotherapy works just as well as antidepressants. Of course, psychotherapists don't have billions of dollars to spend in advertising their services on the evening news.

If you doubt me, I will provide the evidence over the next few weeks.

The first article I have reviewed was published in the August, 2002 issue of none other than the American Journal of Psychiatry.

"Remission in Major Depressive Disorder: A Comparison of Pharmacotherapy, Psychotherapy, and Control Conditions", Nicola Casacalenda, M.D., J. Christopher Perry, M.P.H., M.D. and Karl Looper, M.D.

Here's the study's conclusions:

The percentages of remission for all patients randomly assigned to medication, psychotherapy, and control conditions were 46.4%, 46.3%, and 24.4%, respectively. Furthermore, significantly more patients dropped out of control conditions (54.4%) than either treatment with medication (37.1%) or psychotherapy (22.2%). CONCLUSIONS: Both antidepressant medication and psychotherapy may be considered first-line treatments for mildly to moderately depressed outpatients.

Notice that fewer patients dropped out of the psychotherapy group than the control group or the medication group.

There are other studies which show that the long term gains from psychotherapy are much better than for medications alone and there is less relapse.

Link: Remission in Major Depressive Disorder: A Comparison of Pharmacotherapy, Psychotherapy, and Control Conditions -- Casacalenda et al. 159 (8): 1354 -- American Journal of Psychiatry.

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