Results of counseling, drugs for depression
Researchers comparing the effectiveness of medications and psychotherapy for major depression noted no difference in the success of the two treatment methods after an eight-month clinical investigation.
Psychologist Herbert C. Schulberg, PhD, and colleagues at the University of Pittsburgh School of Medicine in Philadelphia followed 184 patients who were treated in primary care settings by family practitioners or general internists. The findings show significant clinical improvement by patients who received either form of treatment. The treatment type was unrelated to the rate of clinical improvement in those with a higher level of major depression.
However, differences between the treatment types did emerge among those with less severe depression.
This group improved more rapidly when treated with antidepressants instead of psychotherapy. The most improvement occurred during the first two months of treatment. The medication used in the study was nortriptyline hydrochloride.
A major objective of the research was to assess the recommendations of the 1993 American Psychiatric Association and Depression Guideline Panel of the Agency for Health Care Policy and Research that designated antidepressant medications for first-time treatment for moderate to severe major depression while restricting psychotherapy as the sole treatment for depressive episodes of mild-moderate severity. Because the analysis did not find significantly different outcomes when comparing the two treatments, the authors suggest primary care physicians recommend interpersonal psychotherapy for severe major depression when (1) a patient prefers it or (2) a patient refuses or cannot tolerate medications.
For details, see: Schulberg HC, Pilkonis PA, Houck P. The severity of major depression and choice of treatment in primary care practice. J Consult Clin Psychol 1998; 66:932-938.
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