Depression – Drugs vs CBT

Primary Care Corner with Geoffrey Modest MD. BMJ Evidence-Based Medicine Blog

B0005916 The brain and Prozac
Image source: Rowena Dugdale – Wellcome Images // CC BY-NC-ND 4.0

The Agency for Healthcare Research and Quality (AHRQ) just released their clinical review comparing nonpharmacological vs pharmacological treatments for patients with major depressive disorders


  • They reviewed 44 trials from 1990-2015 of patients with mild to severe major depressive disorder (MDD)
  • Cognitive behavioral therapy (CBT) is as effective as second-generation antidepressants (SGAs, which for this review includes SSRIs, SNRIs, bupropion, mirtazapine, nefazodone, and trazodone) for mild to severe MDD, with moderate level of evidence. The evidence does not support SGAs plus CBT as being better than SGAs alone, though this was based on low quality of evidence
  • Therapy (SGA vs CBT) was discontinued at equal rates, for either SGAs or CBT, for adverse effects or patient dissatisfaction

Read the full blog post here

Read the full review here


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