Adolescents with SSRI-resistant depression: CBT plus antidepressant switch more effective than medication switch alone

摘要

Question: What is the best strategy for adolescents with depression who don't respond to initial SSRIs? Patients: 334 adolescents (12-18 years old) with a primary diagnosis of major depressive disorder who had not responded to a 2-month trial with an SSRI. Main exclusions: non-response to >=2 trials of an SSRI or to venlafaxine (>=4 weeks at dose >=150 mg) or CBT (5=7 sessions); already receiving CBT; taking psychoactive medications (except those on stable doses of stimulants or hypnotics for >=12 weeks); bipolar spectrum disorder; psychosis; pervasive developmental disorder or autism; eating disorders; or substance abuse or dependence.