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GPs should give depressed patients choice of drugs or therapy, says study

Talking therapy and antidepressant medication are equally effective for treating major depressive disorder, and therefore GPs should offer both as first-line treatment options to patients, researchers have said.

The study, published today in the BMJ, which compared the clinical outcomes for patients offered either cognitive behavioural therapy (CBT) or a second-generation antidepressant (SSRI, SNRI or other drugs targeting specific neurotransmitters) in isolation, found that there was no difference in responsiveness to treatment.

The researchers, who analysed results of 1,511 patients spread across 11 randomised controlled trials, found that ’available evidence suggests no difference in treatment effects of second-generation antidepressants and cognitive behavioral therapies, either alone or in combination, in major depressive disorder.’

Their report concluded: ’Given that patients may have personal preferences for one first-line treatment over the other, both treatments should be made accessible, either alone or in combination, to primary care patients with major depressive disorder.’

Lead author Dr Gerald Gartlehner, from Danube University, Austria, told Pulse: ’I think the most important point is that patients should have a choice. We now know that antidepressants are not better than CBT but this is not reflected in clinical guidelines for physicians yet (but will be). Doctors need to discuss the pros and cons of antidepressants and CBT with their patients. Some will still want antidepressants, others might choose CBT. The important point is that the decision should be based on informed decision making.’



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