Quick Study

DEPRESSION

Combining drugs and therapy seems to help teens the most.

THE QUESTION Young people who are depressed might be given an antidepressant or prescribed therapy designed to alter their thinking and actions, or sometimes both. Is one treatment better than the others?

THIS STUDY randomly assigned 439 preteens and teens, 12 to 17 years old, most with moderate to severe depression, to one of four treatment groups: daily Prozac (fluoxetine), weekly cognitive behavioral therapy (CBT), both the drug and CBT, or a daily placebo pill. After three months, the placebo was discontinued and the participants in that group were free to select another treatment. The other three groups, which contained 327 participants, all recorded improvement after nine months, on average, with change occurring more quickly among those taking the medication, alone or with therapy. Long-term, however, those considered "much better" or "very much better" based on standardized depression scales included 86 percent of those in the combination group and 81 percent of those in both the drug group and the CBT group. Suicidal thoughts and behavior declined less among those whose treatment was solely the drug.

WHO MAY BE AFFECTED? Preteens and teens experiencing depression, which affects teenage girls more often than boys. The disorder is diagnosed in an estimated 5 to 10 percent of U.S. teenagers each year.

CAVEATS The results do not include a comparison with no treatment because the placebo group was disbanded, for ethical reasons. The findings may not apply to other antidepressants or to other types of therapy. Eli Lilly supplied the antidepressant; one of the 58 authors had received fees from Lilly.

FIND THIS STUDY October issue of Archives of General Psychiatry.

LEARN MORE ABOUT depression in teenagers at http://www.mentalhealthamerica.net and http://www.kidshealth.org/teen (click on "Your Mind").