Which of these treatments is most effective?  This is a question that doesn’t always have a clear answer.  Antidepressants have become the most frequently prescribed drug in doctor’s offices and outpatient clinics today.  In fact, between 1996 and 2005 the number of people in the United States taking antidepressants has doubled in size.

In a recent study, “Psychotherapy Versus Second-Generation Antidepressants in the Treatment of Depression”, researchers attempted to find a more clear answer to this frequently asked question.  This study when compared to past research focused more on comparing the “newest” drugs (i.e. Paxil, Zoloft, and Prozac) to psychotherapy administered by a “qualified” provider.  A majority of previous studies were comparing older drugs to psychotherapy which left an incomplete picture of the comparative effectiveness.

This study was a meta-analysis, meaning they looked at data from 15 studies of similar topics.  In the process of choosing these 15 they had to eliminate studies that were using inadequate treatment methods. This would include studies that included untrained psychotherapists or variables that affected treatment quality such as:  switching of treatments, changing of dosages of medication and/or changing frequency of psychotherapy.  Another factor taken into consideration was the level of depression of the participants.  Depending on severity of depression (mild, moderate, or severe) outcomes and effectiveness of medication and psychotherapy may vary and treatment recommendations may differ.  To improve accuracy this study focused only on participants that were diagnosed with major depressive disorder.

The result of this study found that psychotherapy can be just as effective in the treatment of depression when compared to the newest of antidepressant medications. It was also noted that in the long run psychotherapy showed slightly better results.

So the question is; did they come up with a clear answer?  When comparing risks, benefits, and cost the course of treatment is ultimately up to the individual and their providers.  Some questions to discuss with your doctor might include:

• How severe are my symptoms? How long have I experienced these symptoms?  In what ways do they impair my goals for my health?  Other research has indicated that anti-depressants are most effective for depression that is severe and/or chronic.
• Are their side effects that are more concerning to me?
• What are barriers to me following a treatment?  Can I remember to take medications as directed?  How will I get to appointments for therapy?  Do I have a plan for what to do if I relapse?

We still need more research to be completed that focuses on the effectiveness of these treatments.  Depression today is the fourth leading cause of disability in the United States and it is predicted to be the second by 2020.  It is essential for people with mental illnesses to understand the facts so they can make educated decisions with their doctors about which treatments are most suitable to their specific needs.

This post was written by MHAM Intern Jahna Sandkamp.