Therapy may boost antidepressant drug compliance
July 28, 2004
NEW YORK (Reuters Health) - The combination of drug treatment and psychological therapy for depression is more effective than drug treatment alone. This, researchers report in the Archives of General Psychiatry, may be because patients better adhere to antidepressant drug regimens.
As senior investigator Dr. Carmine Munizza told Reuters Health, "in addition to being a possible alternative to drug treatment, psychotherapeutic intervention in combination with drug therapy has produced outstanding results -- a 12 percent improvement in response rates to drug treatment due to its effect on drop-out rates."
Munizza of Centro Studi e Ricerche in Psichiatria, Turin, Italy and colleagues conducted a review of clinical trials that compared antidepressant treatment alone with the combination approach. The aim was to help clarify the relationship between the type of treatment and the rate of patient compliance with prescribed antidepressant drugs.
In total, the researchers examined 16 trials involving 932 patients randomly assigned to drug treatment and 910 patients assigned to combination therapy.
Overall, improvement was significantly greater in patients in combination therapy - 86 percent -- than in patients who received drug treatment alone.
There were similar proportions of non-responders and drop-outs in both groups. However, in studies lasting more than 12 weeks, the situation changed. In longer studies, combination therapy showed a significant advantage in response and in the likelihood of dropping out.
In longer therapies, the researchers suggest, "Psychotherapy helps to keep patients in treatment." Nevertheless, they concede that specific studies are required "to disentangle the genuine therapeutic effect of psychotherapy," from that of its drug-compliance enhancing qualities.
Meanwhile, they suggest that interventions that encourage drug compliance might be one way of improving the response rate to antidepressant therapy.
Archives of General Psychiatry, July 2004.