Longer Treatment Found to be More Effective in Depressed Teens

A new study shows that the longer depressed teens are treated, the more likely they are to go into remission. The rate of remission for teens who were treated for 36 weeks was more than double that of those who were treated for 12 weeks, regardless of whether the teens were treated with antidepressants, cognitive behavioral therapy, or both. Although the remission rate from the 12-week treatment phase was previously reported to be relatively low at 23 percent, the current study of 36-week treatment found a remission rate across groups of about 60 percent. Betsy Kennard, PsyD, and colleagues in the Treatment Alternatives for Adolescents with Depression Study said that “these findings highlight the importance of continuation and maintenance phase treatments, as the rates of remission improve with time and continued treatment.” Remission rate differences between the groups were apparent only in early treatment. The combination of Prozac and cognitive behavioral therapy was associated with the highest rate of remission as early as week 6 and remained superior to monotherapies of either only Prozac or only cognitive behavioral therapy at weeks 12 and 18. However, by week 24, the rates of remission were similar for all groups. Despite the rates of remission being similar for all groups by week 24, the researchers consider the combination treatment of antidepressants and cognitive behavioral therapy to be more effective. “Selecting a monotherapy could mean delay of remission for a substantial number of depressed adolescent patients by 2 to 3 months,” Kennard and colleagues said. Of the patients who achieved remission in the 12-week treatment phase, 65 to 72 percent maintained it through the 36 weeks of continued treatment, meeting the criteria for full recovery. Although the rate of remission increased with time, many patients remained symptomatic, and about one-third of the patients who attained early remission relapsed within 36 weeks. The researchers observed that the failure to attain or maintain remission with antidepressants, cognitive behavioral therapy, or both points to the remaining challenge in treatment. “It highlights the need to continue to monitor patients even after they have reached remission status,” the authors said.