Adding cognitive behaviour therapy (CBT) to a treatment regime of selective serotonin reuptake inhibitors (SSRIs) and routine clinical care does not appear to contribute to an improved outcome for depressed teenagers.1 A British randomised controlled trial assigned 208 adolescents suffering from moderate to severe major depression to one of two groups. Half received an SSRI and routine care alone, while the remaining participants also underwent weekly CBT for 12 weeks, then fortnightly for 12 weeks. Researchers used several rating scales of depression to assess the outcome at 6, 12 and 28 weeks. A similar proportion of teenagers across the groups showed significant improvement in their depressive symptoms over time, with almost 60% showing improvement by 28 weeks. There was no difference in the incidence of side effects between the treatment arms. An accompanying editorial comments that the evidence suggests monotherapy with an SSRI is reasonable as a treatment for teenagers with moderate to severe depression, but that therapy needs to be of adequate dosage, for a sufficient length of time, and under proper supervision.2
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