Multiple secondary data analyses of TORDIA have identified important predictors of treatment response and relapse .
To up date a comparative effectiveness review ( 1980–2011 ) of treatments for adolescents whose depressive episode or disorder ( MDE/MDD ) did not respond to one or more trials of SSRI antidepressants .
Treatment-resistant depression in adolescents: is the addition of cognitive behavioral therapy of benefit?
Background Many young people with major depression fail first-line treatments . Treatment-resistant depression has various definitions in the literature but typically assumes nonresponse to medication . In young people , cognitive behavioral therapy ( CBT ) is the recommended first-line intervention , thus the definition of treatment resistance should be exp and ed . Therefore , our aim was to synthesize the existing evidence of any interventions for treatment-resistant depression , broadly defined , in children and adolescents and to investigate the effectiveness of CBT in this context . Methods We used Cochrane Collaboration methodology , with electronic search es of Medline , PsycINFO , Embase , and the Cochrane Depression Anxiety and Neurosis Group trials registers . Only r and omized controlled trials were included , and were assessed for risk of bias . Meta- analysis was undertaken where possible and appropriate . Results Of 953 articles retrieved , four trials were eligible for inclusion . For one study , only the trial registration document was available , because the study was never completed . All other studies were well conducted with a low risk of bias , although one study had a high dropout rate . Two studies assessed the effect of adding CBT to medication . While an assertive trial of antidepressants does appear to lead to benefit , when compared with placebo , there was no significant advantage , in either study , or in a meta- analysis of data from these trials , that clearly demonstrated an additional benefit of CBT . The third trial showed little advantage of a tricyclic antidepressant over placebo in the context of an inpatient admission . Conclusion Few r and omized controlled trials have investigated interventions for treatment-resistant depression in young people , and results from these show modest benefit from antidepressants with no additional benefit over medication from CBT . Overall , there is a lack of evidence about effective interventions to treat young people who have failed to respond to evidence -based interventions for depression . Research in this area is urgently required
Multiple secondary data analyses of TORDIA have identified important predictors of treatment response and relapse .
To up date a comparative effectiveness review ( 1980–2011 ) of treatments for adolescents whose depressive episode or disorder ( MDE/MDD ) did not respond to one or more trials of SSRI antidepressants .