Depression is predicted to become the leading cause of disability in high income countries by 2030, and currently only a third of patients with depression respond fully to antidepressant medication.
Only a third of patients with depression respond fully to antidepressant medication but little evidence exists regarding the best next-step treatment for those whose symptoms are treatment resistant.
The CoBalT trial aimed to examine the effectiveness of cognitive behavioural therapy (CBT) as an adjunct to usual care (including pharmacotherapy) for primary care patients with treatment resistant depression compared with usual care alone.
In an Article, Nicola Wiles and colleagues present the results of the CoBalT trial which demonstrates the effectiveness of CBT in reducing depression. A total of 469 patients were recruited to this large scale randomised trial, and results show that 46% of participants who received CBT in addition to usual care reported at least a 50% reduction in depressive symptoms, compared with 22% of those who continued with treatment as usual.
Before this study, no evidence from large-scale randomised controlled trials was available for the effectiveness of augmentation of antidepressant medication with CBT as a next-step for patients whose depression has not responded to pharmacotherapy. Our study has provided robust evidence that CBT as an adjunct to usual care that includes antidepressants is an effective treatment, reducing depressive symptoms in this population.
Source: Lancet, UK