title: Comparative efficacy of cognitive behavioral therapy, fluoxetine, and their combination in depressed adolescents: initial lessons from the treatment for adolescents with depression study.
abstract: Adolescents with major depressive disorder (MDD), their families and clinicians experience significant challenges when weighing the potential risks versus benefits of available choices in the treatment of MDD. Although MDD is highly prevalent in adolescents and is associated with marked suffering, impairment and risk of suicide, the scientific data regarding the safety and efficacy of treatments for pediatric depression are limited. Controlled clinical trials have provided support for the use of psychotherapy and fluoxetine for the treatment of pediatric depression, but until recently no information on the comparative efficacy of these recommended interventions alone or in combination was available. The Treatment for Adolescents with Depression Study provides a very important therapeutic advance in the field by convincingly showing that combination treatment with cognitive behavioral therapy and fluoxetine has the best benefit to risk ratio for adolescents with moderate to severe depression, and is superior to monotherapy. Moreover, the study results confirm that fluoxetine alone is effective in the treatment of depressed adolescents.
authors.affiliation: University of Cincinnati College of Medicine, Children's Hospital Medical Center, MLC # D-3014, 3333 Burnet Avenue, Cincinnati, OH 45229, USA. sanjeev.pathak@cchmc.org
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Pathak
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Kratochvil
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Rogers
authors.forename: Susan
authors.initials: S
authors.lastname: Silva
authors.forename: Benedetto
authors.initials: B
authors.lastname: Vitiello
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Weller
authors.forename: John S
authors.initials: JS
authors.lastname: March
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002986:Clinical Trials as Topic; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013405:Suicide; D016896:Treatment Outcome
chemical_list: D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors