Pmetro meds12/11/2023 ![]() ![]() ![]() Few of the comparative studies he analyzed, said Spielmans, followed up with patients for more than six months.Ī gap in the researchSpielmans said he decided to do the meta-analysis because “I was getting tired of reading about how psychotherapy compared to old meds, which aren’t used very much any more. ![]() In fact, in the long term, bona fide psychotherapy may provide better results than medication, said the study’s lead author, Metro State assistant psychology professor Glen Spielmans. Paul and Dartmouth College in New Hampshire has found.īut the psychotherapy treatment has to be “bona fide” - that is, conducted by qualified therapists using well-validated methods of face-to-face therapy, the study also found. Psychotherapy can be as effective for the treatment of depression as the most recent generation of antidepressant medications, a new meta-analysis from researchers at Metropolitan State University in St. MaPsychotherapy is as effective as meds for treatment of depression, Metro State study finds Psychotherapy is as effective as meds for treatment of depression, Metro State study finds Meanwhile, the use of psychotherapy has declined. Between 19, the number of Americans receiving antidepressants doubled - and 90 percent of the drugs being prescribed are second-generation ones. In the United States, antidepressants are the most frequently prescribed drugs in doctors’ offices and other outpatient clinics. For, as Spielmans and Berman point out in their study’s background information, depression is the fourth-leading cause of disability worldwide and is expected to rank second (behind heart disease) by 2020. Obviously, more - and better - comparative research is needed. That made it difficult, said Spielmans, to determine which type of treatment was most effective over the long term. One study even allowed participants to continue on their meds during follow-up, but not to continue with psychotherapy. In addition to the fact that some used non-bona-fide psychotherapies for their comparisons, the studies also permitted varying lengths of contact between patients and therapists. The meta-analysis, which appears in the March issue of the Journal of Nervous and Mental Disease, had several limitations, many having to do with the studies’ widely varying methodologies, said Spielmans. “Certainly in the short term, medication is cheaper, but if psychotherapy produces better long-term results, then you could make an argument that it’s more cost-effective,” said Spielmans. Much depends, for example, on whether a patient is taking a patented or a generic version of an antidepressant. But in terms of cost, he added, the equation is more complex. “In terms of side effects, psychotherapy would have an advantage,” said Spielmans. What do these findings mean in terms of risks versus benefits - and costs? Trained practitioners were always involved in the medication arm of the 15 studies. “Those therapies didn’t do very well,” said Spielmans. “I’m not surprised that drug companies don’t fund it.”)Īfter crunching the data in the studies, Spielmans and Berman found little difference in outcomes - including patient dropout rates - between psychotherapy and medication treatments for depression, except when the psychotherapy was non-bona fide (that mostly meant not delivered by qualified, licensed psychotherapists). “Obviously, there’s a risk from doing that kind of research,” said Spielmans. (Interestingly, only one study was funded by a drug company. The researchers identified 15 studies that met these criteria. In addition, the studies’ participants could not be on other psychotropic medications (like lithium), and the data had to include sufficient information to determine how much of an effect the treatment had on individuals. They narrowed their search to studies that compared a second-generation antidepressant with psychotherapy in adults with diagnosed major depressive disorder. So he and Margit Berman, an associate professor of psychiatry at Dartmouth, decided to conduct a review of studies that had directly compared psychotherapy to second-generation antidepressants - drugs like Paxil, Zoloft and Prozac. No one had really focused on comparing newer antidepressants with psychotherapy.” Spielmans said he decided to do the meta-analysis because “I was getting tired of reading about how psychotherapy compared to old meds, which aren’t used very much any more. “When you hear ‘long-term results,’ you’re really talking about a few months after treatment has been discontinued,” he added. ![]()
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