Skip to main content
release_alert
Welcome to the new Scholars 3.0! Read about new features and let us know what you think.
cancel

Chronic depression: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not.

Publication ,  Journal Article
Schatzberg, AF; Rush, AJ; Arnow, BA; Banks, PLC; Blalock, JA; Borian, FE; Howland, R; Klein, DN; Kocsis, JH; Kornstein, SG; Manber, R ...
Published in: Arch Gen Psychiatry
May 2005

CONTEXT: Although various strategies are available to manage nonresponders to an initial treatment for depression, no controlled trials address the utility of switching from an antidepressant medication to psychotherapy or vice versa. OBJECTIVE: To compare the responses of chronically depressed nonresponders to 12 weeks of treatment with either nefazodone or cognitive behavioral analysis system of psychotherapy (CBASP) who were crossed over to the alternate treatment (nefazodone, n = 79; CBASP, n = 61). DESIGN: Crossover trial. SETTING: Twelve academic outpatient psychiatric centers. PATIENTS: There were 140 outpatients with chronic major depressive disorder; 92 (65.7%) were female, 126 (90.0%) were white, and the mean age was 43.1 years. Thirty participants dropped out of the study prematurely, 22 in the nefazodone group and 8 in the CBASP group. INTERVENTIONS: Treatment lasted 12 weeks. The dosage of nefazodone was 100 to 600 mg/d; CBASP was provided twice weekly during weeks 1 through 4 and weekly thereafter. MAIN OUTCOME MEASURES: The 24-item Hamilton Rating Scale for Depression, administered by raters blinded to treatment, the Clinician Global Impressions-Severity scale, and the 30-item Inventory for Depressive Symptomatology-Self-Report. RESULTS: Analysis of the intent-to-treat sample revealed that both the switch from nefazodone to CBASP and the switch from from CBASP to nefazodone resulted in clinically and statistically significant improvements in symptoms. Neither the rates of response nor the rates of remission were significantly different when the groups of completers were compared. However, the switch to CBASP following nefazodone therapy was associated with significantly less attrition due to adverse events, which may explain the higher intent-to-treat response rate among those crossed over to CBASP (57% vs 42%). CONCLUSIONS: Among chronically depressed individuals, CBASP appears to be efficacious for nonresponders to nefazodone, and nefazodone appears to be effective for CBASP nonresponders. A switch from an antidepressant medication to psychotherapy or vice versa appears to be useful for nonresponders to the initial treatment.

Duke Scholars

Published In

Arch Gen Psychiatry

DOI

ISSN

0003-990X

Publication Date

May 2005

Volume

62

Issue

5

Start / End Page

513 / 520

Location

United States

Related Subject Headings

  • Triazoles
  • Treatment Outcome
  • Survival Analysis
  • Regression Analysis
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Piperazines
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schatzberg, A. F., Rush, A. J., Arnow, B. A., Banks, P. L. C., Blalock, J. A., Borian, F. E., … Keller, M. B. (2005). Chronic depression: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not. Arch Gen Psychiatry, 62(5), 513–520. https://doi.org/10.1001/archpsyc.62.5.513
Schatzberg, Alan F., A John Rush, Bruce A. Arnow, Phillip L. C. Banks, Janice A. Blalock, Frances E. Borian, Robert Howland, et al. “Chronic depression: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not.Arch Gen Psychiatry 62, no. 5 (May 2005): 513–20. https://doi.org/10.1001/archpsyc.62.5.513.
Schatzberg AF, Rush AJ, Arnow BA, Banks PLC, Blalock JA, Borian FE, et al. Chronic depression: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not. Arch Gen Psychiatry. 2005 May;62(5):513–20.
Schatzberg, Alan F., et al. “Chronic depression: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not.Arch Gen Psychiatry, vol. 62, no. 5, May 2005, pp. 513–20. Pubmed, doi:10.1001/archpsyc.62.5.513.
Schatzberg AF, Rush AJ, Arnow BA, Banks PLC, Blalock JA, Borian FE, Howland R, Klein DN, Kocsis JH, Kornstein SG, Manber R, Markowitz JC, Miller I, Ninan PT, Rothbaum BO, Thase ME, Trivedi MH, Keller MB. Chronic depression: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not. Arch Gen Psychiatry. 2005 May;62(5):513–520.

Published In

Arch Gen Psychiatry

DOI

ISSN

0003-990X

Publication Date

May 2005

Volume

62

Issue

5

Start / End Page

513 / 520

Location

United States

Related Subject Headings

  • Triazoles
  • Treatment Outcome
  • Survival Analysis
  • Regression Analysis
  • Psychiatry
  • Psychiatric Status Rating Scales
  • Piperazines
  • Male
  • Humans
  • Female