Combination of Medication and Psychotherapy Produce Dramatic Improvement in Chronic Depression.

STANFORD, Calif.--(BW HealthWire)--May 19, 1999--

A new combination of drug therapy and a specific form of psychotherapy has produced dramatic results in treating long-term depression, according to a national study presented Wednesday, May 19, at the annual meeting of the American Psychiatric Association in Washington, D.C.

While the psychotherapy alone or the use of the study medication alone can produce successful results, "the added value of the combination treatment produced dramatic results -- faster and more successful improvement than any I've ever heard about from a depression study," said Charles DeBattista, MD, director of the Depression Research Clinic and assistant professor of psychiatry and behavioral sciences at Stanford University School of Medicine.

A total of 681 patients who had suffered from depression for two years or more were selected at 12 academic medical centers nationwide for the 80-week study. DeBattista said about 80 patients were in the Stanford group.

Results from the acute phase of treatment -- the first 12 weeks -- showed that the combination of the study drug nefazodone and psychotherapy produced significant benefit in 85 percent of the patients, as measured by a common scale used to evaluate depression. The drug alone produced a 55 percent rate of success, about the same as the 52 percent rate for psychotherapy.

The drug is marketed as Serzone by Bristol-Myers Squibb Co., which sponsored and paid for the national study.

DeBattista said the study showed that use of the drug alone was comparable to results found in previous studies for other antidepressant drugs. The psychiatrist said further studies would need to be conducted to determine if other common antidepressants, including sertraline, imipramine and desipramine, could produce the same results when combined with the specialized form of psychotherapy, called the Cognitive Behavioral Therapy for Chronic Depression.

The psychotherapy involves education to help the patient understand emotional triggers affecting his or her life. DeBattista said it was unknown whether other forms of psychotherapy would produce similar results.

"We think this study gives a strong indication that combination therapies might be of value to the 14 million people who suffer from chronic depression, even though the costs to providers or to individuals are obviously higher than one form of treatment alone," DeBattista said. Chronic depression is defined as depression existing for more than two years.

The lead investigator at Stanford was Alan Schatzberg, MD, professor and chair of psychiatry and behavioral sciences. Nationally, the lead investigator was Martin B. Keller, MD, professor and chair of the Department of Psychiatry and Human Behavior at Brown University School of Medicine.