THERAPEUTICS
Adolescents with SSRI-resistant depression: CBT plus antidepressant switch more effective than medication switch alone
| The first 150 words of the full text of this article appear below. |
What is the best strategy for adolescents with depression who don’t respond to initial SSRIs?
334 adolescents (12–18 years old) with a primary diagnosis of major depressive disorder who had not responded to a 2-month trial with an SSRI. Main exclusions: non-response to 
2 trials of an SSRI or to venlafaxine (4 weeks at dose 150 mg) or CBT (7 sessions); already receiving CBT; taking psychoactive medications (except those on stable doses of stimulants or hypnotics for 12 weeks); bipolar spectrum disorder; psychosis; pervasive developmental disorder or autism; eating disorders; or substance abuse or dependence.
US academic and community clinics; 2000–2006.
One of four 12-week regimens: switch to a second, different SSRI (paroxetine, fluoxetine or citalopram at 20–40 mg daily); switch to venlafaxine (150–225 mg daily); switch to second SSRI plus CBT; switch to venlafaxine plus CBT. CBT was delivered by experienced therapists with at least master’s level
Locum Consultant in Adolescent Psychiatry, Lancaster, and Honorary Lecturer, University of Manchester, UK
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