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New Medications, Treatment May Help Teens With Depression

More than one third of teenagers with treatment-resistant depression—many of whom had been depressed for more than two years—became symptom-free six months after switching their medication or combining a medicine switch with cognitive behavioral therapy during a multicenter study led by UT Southwestern Medical Center researchers.

The study findings, available online in the American Journal of Psychiatry, found that teenagers who showed an improvement of symptoms after just three months into their new regimen were much more likely to show lasting beneficial effects.

“This study provides hope for parents and teenagers that persistence in seeking treatment will lead to recovery in some patients, especially if early treatment is aggressive,” says Graham Emslie, MD, a professor of psychiatry and pediatrics at UT Southwestern and a principal investigator of the study. “Even after six months of treatment, however, about two third of teenagers were still suffering from at least some symptoms of depression.”

The 334 study participants ranged from the age of 12 to 18. They exhibited traits of moderate to severe major depressive disorder, including thoughts of suicide. Historically, these types of patients have the worst treatment outcomes.

In February 2008, the researchers first published work about these teenagers, who had failed to respond to selective serotonin reuptake inhibitors (SSRIs). After three months, nearly 55% of the teens in the study improved when they both switched to a different antidepressant and participated in cognitive behavioral therapy, which examines thinking patterns to modify behavior. That study also found that after three months, about 41% of participants showed improvement after just switching to either a different SSRI or to venlafaxine, a non-SSRI type of depression medication.

After examining the six-month data from that study, researchers found that nearly 39% of participants who completed six months of treatment no longer had symptoms of depression. Those participants were more likely to have had lower levels of depression, hopelessness, and anxiety at the beginning of the study.

Those who responded to the new regimen during the first three months were more likely to achieve remission, meaning minimal symptoms of depression or no symptoms at all. Many of those participants, who came from six sites across the country, responded during the first six weeks of treatment.

Current treatment guidelines suggest staying with a treatment for at least two to three months before trying another treatment.

“In light of our new findings, those guidelines may need to be revisited because these latest results suggest more aggressive treatment early on may improve outcomes,” says Emslie.

— Source: UT Southwestern Medical Center