title: Cognitive behavior approach to loss of clinical effect during long-term antidepressant treatment: a pilot study.
abstract: OBJECTIVE
  The aims of this investigation were to explore the feasibility of a cognitive behavior approach to loss of clinical effect during long-term antidepressant therapy and to compare it with dose increase.
  
  
  METHODS
  Ten patients with recurrent depression who relapsed while taking antidepressant drugs were randomly assigned to dose increase and clinical management or to cognitive behavior therapy and maintenance of the antidepressant drug at the same dose.
  
  
  RESULTS
  Four of five patients responded to a larger dose, but all had relapsed again on that dose by the 1-year follow-up. Four of five patients responded to cognitive behavior therapy, and only one relapsed during follow-up.
  
  
  CONCLUSIONS
  The data suggest that application of a cognitive behavior therapy approach is feasible when there is a loss of clinical effects during long-term antidepressant treatment and may carry long-term benefits. The results need to be confirmed with large-scale controlled studies.
authors.affiliation: Affective Disorder Program and Laboratory of Experimental Psychotherapy, Department of Psychology, University of Bologna, viale Berti Pichat 5, 40127 Bologna, Italy. fava@psibo.unibo.it
authors.forename: Giovanni A
authors.initials: GA
authors.lastname: Fava
authors.forename: Chiara
authors.initials: C
authors.lastname: Ruini
authors.forename: Chiara
authors.initials: C
authors.lastname: Rafanelli
authors.forename: Silvana
authors.initials: S
authors.lastname: Grandi
mesh_terms: D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D006801:Humans; D010865:Pilot Projects; D012008:Recurrence; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents