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Survey: Talk Therapy as Good as Antidepressants

Consumer Reports Survey Shows Both Treatments Are Effective for Depression and Anxiety

Tracking Depression and Anxiety continued...

Overall, a psychiatrist got a somewhat higher helpfulness score from the readers. But in general, the advantages of talk therapy were consistent whether the therapist was a psychologist, social worker, or licensed counselor.

Those who stuck with the talk therapy for seven sessions or more had better results than those who completed fewer.

When single vs. combined treatment was considered, taking into account how helpful readers found their therapist or doctor, how much change they reported in emotional health, and other factors, those who used drugs and engaged in talk therapy for at least seven visits fared the best, according to Metcalf.

Second Opinion

In response to the survey results (including the finding of fewer side effects with Prozac than with Cymbalta), Charles McAtee, a spokesman for Eli Lilly and Company, which makes both of the drugs, says in a statement: "Depression is a highly individualized illness. Treatment decisions, including what type of treatment is appropriate for a given patient, are best determined by the health care professional and patient working together and based on the individual patient's needs."

''As with any medication," McAtee states, "Prozac and Cymbalta can include side effects, so patients should speak with their doctor about the risks and benefits of any antidepressant  medication before starting treatment."

The report offers some good information, but there's a caveat, says Harold Pincus, MD, vice chairman of psychiatry at Columbia University, New York, who has researched and published on trends in depression treatment.

''A lot of the information is pretty sound," says Pincus, who reviewed the report for WebMD. But, he adds, it has flaws inherent in any survey.

"We have no idea who the respondent pool is, whether they are representative of the general population," he says. (The Consumer Reports authors note that they are not necessarily representative of the general U.S. population). Those who are depressed or anxious who answered the survey may also not be typical of those in the general population with the conditions, he says.

''The bottom line is, it's not something I would rely on for decision making," Pincus says.

Deciding which treatments to recommend for mental health issues, he says, is complicated, with many factors needing to be taken into account. Among them are the degree of symptoms, the patient's medical and family history, and past experiences with medications and other therapies.

If the depression is very mild, he says, "watchful waiting" for a couple of weeks may be best, as the depression may lift on its own.

If the depression is mild, he says, psychotherapy or medications can be used with equal benefit. ''For those with moderate to severe major depression, medication is more effective than psychotherapy alone, but the two together may be synergistic because they may attack different components of the illness."

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