Fluoxetine added to CBT offers little benefit for youth depression

  • Lancet Psychiatry

  • International Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • The addition of fluoxetine to cognitive behavioral therapy (CBT) does not enhance outcomes for youth with moderate-severe depression.
  • There is some hint of benefit for older youth (more than age 18 years) and for amelioration of anxiety symptoms.

Why this matters

  • The addition of pharmacotherapy to CBT for depression treatment in young people has been controversial.

Key results

  • Adding fluoxetine to CBT did not improve scores on the Montgomery-Åsberg Depression Rating Scale (MADRS) vs placebo+CBT after 12 weeks of therapy.
  • Both groups showed reduced MADRS scores, however:
    • CBT+fluoxetine: −15.1 (95% CI, −17.4 to −12.9).
    • CBT+placebo: −13.7 (95% CI, −16.0 to −11.4).
  • Attempts at suicide did not differ between the groups (P=.21), nor did remission rates (P=.54).
  • However, anxiety symptoms decreased significantly with fluoxetine added (P=.02).
  • MADRS decreased a little more steeply with fluoxetine among participants older than age 18 years.

Study design

  • Randomized, double-blind, placebo-controlled, multicenter Youth Depression Alleviation–Combined Treatment trial, included 153 care-seeking youth ages 15-25 years with moderate-severe depression, Australia.
  • Participants were randomly allocated to 12 weeks of CBT+fluoxetine vs CBT+placebo.
  • Outcome: change in MADRS.
  • Funding: Australian National Health and Medical Research Council.

Limitations

  • Small numbers in study.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit