No significant differences were found between second-generation antidepressants and cognitive-behavioral therapy (CBT) in treating major depressive disorder in adults, according to a meta-analysis by Halle R. Amick and associates.
For the meta-analysis, 11 trials were included. The differences in treatment effectiveness between antidepressants and CBT were minimal and not significant. The risk ratio of antidepressants, compared with CBT for response was 0.91 and 0.98 for remission. The mean difference between antidepressants and CBT on the Hamilton Rating Scale for Depression was –0.38, the investigators reported.
There was no significant difference in overall study discontinuation between people taking antidepressants and people using CBT (risk ratio, 0.90), or in study discontinuation because of lack of efficacy (RR, 0.40). Patients treated with antidepressants were more likely to experience study discontinuation tied to adverse events than patients receiving CBT. However, the difference was not statistically significant (RR, 3.29).
“Given that the benefits of second-generation antidepressants and cognitive-behavioral therapy do not seem to differ significantly in treating major depressive disorder and that primary care patients may have personal preferences for one first-line treatment over the other, both treatments should be made accessible, either alone or in combination, to primary care patients with major depressive disorder,” the investigators said.
Find the full study in the BMJ (doi: 10.1136/bmj.h6019).