Antidepressants seem to be no better at treating major depressive disorders than seeing a therapist, according to the findings of a new study.
At five years, cognitive behavioral therapy and second-generation antidepressants were about equal in efficacy and cost-effectiveness, according to University of Michigan researchers, who published their findings earlier this month in The Annals of Internal Medicine.
Researchers used data from an analysis of randomized controlled trials, as well as additional clinical and economic data from other publications. They included adults with a new diagnosis of major depressive disorder in the U.S.
Most guidelines for depression recommend treatment with antidepressants or cognitive behavioral therapy. Many people opt for simply taking a pill, rather than spending the time week after week in therapy. In this study, researchers set out to determine if one was superior to the other.
According to the findings, both produced similar quality adjusted life years. At the one-year mark, therapy produced three days more of quality adjusted life years than antidepressants. At the five-year mark, therapy produced 20 more days.
Similarly, therapy cost patients more by one year, but at five years it had lower costs.
A cost analysis showed antidepressants had a 64% to 77% likelihood of having a cost effectiveness ratio of $100,000 per quality life year while therapy had a 73% to 77% likelihood at five years.
Since both are fairly equal in treatment and cost effectiveness, which therapy to use should be determined based on other factors, such as individual patient values and preferences, the researchers concluded. They indicated that increasing patient access to therapy should be a focus in the future, given the results.
Study authors found that more people newly diagnosed to depression should first try therapy, either individually or in group sessions, before deciding to take an antidepressant. Taking antidepressant drugs can always be a follow-up option if therapy doesn’t seem to be helping in the long run.
“Neither antidepressants nor cognitive behavioral therapy provides consistently superior cost-effectiveness relative to the other,” the researchers concluded. “Given many patients’ preference for psychotherapy over pharmacotherapy, increasing patient access to cognitive behavioral therapy may be warranted.”