Depressed Teens Respond Best to Fluoxetine Plus Therapy

Response rate greatest in cognitive behavioral therapy plus fluoxetine arm of randomized controlled trial

THURSDAY, Oct. 4 (HealthDay News) -- Combination therapy with fluoxetine and cognitive behavioral therapy (CBT) for the treatment of depression in adolescents appears to be superior to monotherapy with either treatment alone, according to the results of a randomized controlled trial published in the October issue of the Archives of General Psychiatry.

As part of the Treatment for Adolescents with Depression Study (TADS), John S. March, M.D., of Duke University Medical Center in Durham, N.C., and colleagues randomized 327 adolescents aged 12 to 17 with major depressive disorder to receive fluoxetine, CBT, or combination therapy. Patients were followed for 36 weeks and response was measured by Clinical Global Impressions-Improvement scores.

Intention-to-treat analysis revealed a significant time x treatment interaction. Response rates at 12 weeks were 73 percent, 62 percent and 48 percent for combination, fluoxetine and CBT, respectively. At 36 weeks, response rates were 86 percent for combination therapy and 81 percent for both fluoxetine and CBT groups. Suicidal ideation decreased with treatment, but fluoxetine therapy was associated with more suicidal events (14.7 percent) than combination therapy (8.4 percent) or CBT (6.3 percent). There were no completed suicides in the study.

"Taking benefits and harms into account, combined treatment appears superior to either monotherapy as a treatment for major depression in adolescents," the authors conclude.

Eli Lilly and Company provided fluoxetine and matching placebo, but had no other role in the study.

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Physician’s Briefing Staff

Updated on June 10, 2022

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