The combination of psychotherapy and antidepressants

Depression and anxiety disorders affect an increasing number of Canadians each year. According to the Canadian Mental Health Association, 5% of the population has anxiety disorders, while approximately 8% of Canadians will experience major depression at some point in their lives. Treatments for these two types of conditions are similar and can be very effective in reducing symptoms towards remission. This involves pharmacological treatments such as antidepressants to relieve the individual, or psychological treatment such as psychotherapy.

It has been observed that there is synergy between medication and psychotherapy. Indeed, an analysis combining several studies comparing the effects of medication alone with the effects of combination therapy with psychotherapy concluded that the combination was significantly more effective for the treatment of major depression and certain anxiety disorders, notably panic disorder and obsessive-compulsive disorder. According to the analysis, more patients achieved remission and did so more quickly with combined treatment. Moreover, this strategy of combining psychotherapy and antidepressants appears to be even more effective in older patients.

In light of the results of this analysis, the Canadian Psychiatric Association and the Canadian Network for Mood and Anxiety Treatments consider psychotherapy, specifically “cognitive-behavioral” and “interpersonal” types, as a first-line treatment for acute and maintenance treatments against depression and anxiety disorders. While cognitive-behavioral therapy targets specific symptoms with practical exercises and therapist interventions, interpersonal therapy aims to help the patient regain control of their mood by addressing interpersonal relationships and how the surroundings can help them achieve this goal.

Specialized clinics exist in Quebec to offer this type of treatment, which may be partially covered by some private insurers. While psychotherapy may seem intimidating to some, one should not shy away from this treatment option as it does indeed have positive and additive effects on the primary goal of achieving remission!

References:

1 – Cuijpers P, Sijbrandij M, Koole SL, Andersson G, Beekman AT, Reynolds CF. Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry. 2014;13(1):56-67. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918025/

2 – Lam RW, Kennedy SH, Grigoriadis S, McIntyre RS, Milev R, Ramasubbu R, Parikh SV, Patten SB, Ravindran AV; Canadian Network for Mood and Anxiety Treatments (CANMAT). Canadian Network for Mood and Anxiety Treatments (CANMAT) clinical guidelines for the management of major depressive disorder in adults. III. Pharmacotherapy. J Affect Disord. 2009 Oct;117 Suppl 1:S26-43. Available at: http://www.canmat.org/resources/CANMAT%20Depression%20Guidelines%202009.pdf