Talk Therapy Plus Meds Best for Severe Depression?
Combination isn't better than drugs alone for those with mild or chronic mood disorder, study says
The doctors treated the patients until their depression went away, and then kept up treatment for six months. If patients made it six months without relapsing into depression, they had experienced a full recovery, Hollon said.
For those who experienced a full recovery, the combination treatment appeared to help most. About 73 percent of patients who received therapy and medication made a full recovery, compared with 63 percent of patients receiving medication alone, according to the researchers.
Combination treatment particularly helped people with short-term but severe depression, leading 81 percent to full recovery versus 52 percent for those receiving medication alone.
People with mild depression did not get any better help from combination treatment than from drugs alone, nor did people with chronic severe depression, the investigators found.
It's likely that people with mild depression only need medication -- or even the suggestion of medication -- to bounce back and remain healthy, Hollon said.
"For people who have less severe or non-chronic depression, we know you get a very high placebo rate," he said. "Those people do better on anything."
On the other hand, people with deep and long-lasting depression appear hard to reach by any means. "For whatever reason, for people with chronic depression, we haven't found a way to help those people out," Hollon said.
Hollon noted that all depression patients who received combination treatment had fewer serious events -- such as psychiatric hospitalization, medical hospitalization and suicide attempts -- than patients who received medication alone.
"Having the additional therapy component with medication helps patients with depression, clinically," Krakower said. "Medication and therapy should still be used in combination as much as possible, until we know more."
Hollon's team will continue to observe the patients over time, to see how many will be able to remain depression-free for the long term.