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The influence of baseline severity has been examined for antidepressant medications but has not been studied properly for cognitive–behavioural therapy (CBT) in comparison with pill placebo. You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Suzanne Dash on a meta-analysis of CBT and antidepressants for depression that looked at negative & positive responses and what predicted different outcomes
ABSTRACT FROM: Amick HR, Gartlehner G, Gaynes BN, et al. Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis. BMJ 2015;351:h6019.
What is already known on this topic
There is a pressing need to generate clear hierarchies of the benefits and harms of available treatments to implement optimal clinical practice. Second-generation antidepressants (SGAs) and cognitive–behavioural therapy (CBT) have proven efficacy in the treatment of major depression.1 However, comparative benefits and harms of SGAs and CBT for the initial treatment for major depression remain unclear. To read the full article, log in using your NHS OpenAthens details.
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This review found no difference in effectiveness or drop-out rates between antidepressants and cognitive behavioural therapy for adults recently diagnosed with major depressive disorder. Both treatments should be offered, as recommended by NICE, either alone or possibly in combination, and the final decision will rely heavily on the patient’s preference.
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Available evidence suggests no difference in treatment effects of second generation antidepressants and CBT, either alone or in combination, although small numbers may preclude detection of small but clinically meaningful differences.