Cognitive Behavioral Therapy (CBT) may trump SSRIs for Major Depressive Disorder (MDD).*** Prophylactic efficacy of fluoxetine, escitalopram, sertraline, paroxetine, and concomitant psychotherapy in major depressive disorder: Outcome after long-term follow-up Psychiatry Research, 12/05/2014 Peselow ED, et al. – This study aims at examining the prophylactic effectiveness of four commonly used SSRIs in MDD in a naturalistic setting with long-term follow-up, the effect of concomitant Cognitive Behavioral Therapy (CBT), and the predictors of outcome. The preliminary data may help in defining the clinical utility of antidepressants and CBT in the prophylaxis of MDD. Methods: In a prospective cohort study, 387 patients who either remitted or responded following treatment with four different SSRIs - fluoxetine, escitalopram, sertraline and paroxetine - were followed up over several years. Results: During an average follow-up period of 34.5 months, 76.5% of patients experienced MDD recurrence. Escitalopram and fluoxetine showed a numerically higher prophylactic efficacy than paroxetine and sertraline but the difference was insignificant. Concluding limited prophylaxis effectiveness for SSRI-only treatment, with a recurrence rate of 82.0%. Compared to 59.0% of patient recurrence rate in concomitant CBT increased prophylactic efficacy of antidepressant treatment. The relatively small size of the CBT and the lack of randomization may undermine the extrapolation of its findings to clinical practice.
Posted on: Fri, 05 Dec 2014 11:45:27 +0000
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