Adding CBT Helps Teens if SSRIs Don't Work

Adding cognitive behavioral therapy (CBT) can be helpful for teens who are not responding to SSRIs, says a new study.

The Treatment of SSRI-Resistant Depression in Adolescents (TORDIA) trial included 12- to 18-year old patients with major depression who did not have an adequate response to an SSRI. Altogether, 344 patients from six US centers were enrolled in the study between 2000 and 2006.

All patients were randomly assigned to one of four 12-week treatment regimens:

1. They were switched to a different SSRI.
2. They were switched to a different SSRI plus given CBT.
3. They were switched to Effexor.
4. They were switched to Effexor plus given CBT.

The researchers found that the patients responded better to the treatment regimens which included CBT, regardless of whether they were given another SSRI or Effexor. There was no difference between the groups given an SSRI alone or Effexor alone.

Given that 40% of depressed teens do not have an adequate response to initial treatment with an SSRI, this study is significant in that it provides clinicians with information about how to best treat these non-responders.

The study appears in the February 27 issue of JAMA.