Relapse prevention in depression : psychotherapy combined with antidepressants vs antidepressants alone

Abstract

There are different treatment modalities that are prescribed to individuals with depression. These include psychotherapy, anti-depressants or a combined therapy of both methods. The main aim in the management of depression is to regain stabilization of the symptoms and additionally prevent relapse in the future. The research question reads: Is psychotherapy combined with antidepressants more effective than antidepressants alone in relapse prevention amongst adults with depression? The PICO elements consists of: Adults with depression as the population, the intervention consists of Psychotherapy combined with antidepressants, comparison is Antidepressants alone and the outcome is the prevention of relapse. Inclusion criteria consisted of Adults, Relapse Prevention, Combined therapy, Antidepressants and Psychotherapy. Exclusion criteria consisted of Studies not in English language and not available in full text, not peer reviewed studies, studies published later than ten years, older adults, children and adolescents, articles which included comorbidities. The outcome of the search was intended to identify which treatment modality is the most efficacious in preventing relapse amongst individuals with depression. The two treatment modalities consisted of combined therapy of antidepressants and psychotherapy and the monotherapy of antidepressants alone. The CASP was used as the critical appraisal tools to evaluate both RCTs and Meta-analysis. Two versions, one for the RCTs and one for the Metaanalysis were used accordingly. The main results in view of different treatment modalities in preventing relapse in depression favoured combination therapy of antidepressants and psychotherapy over antidepressants alone. It is evident that the follow up care in the studies need to be longer. Another important aspect is that studies need to include individuals that have severe depression as well. There is the need of more research in the local scenario as this is strongly lacking.