Prevention of Recurrence in Depression With Drugs and Cognitive Therapy

We are conducting a study to determine just how long patients need to stay on medications to prevent the onset of new episodes and whether adding cognitive therapy to medications can prevent future episodes among recovered patients. People who are clinically depressed will be randomly assigned to either combined treatment (antidepressant medicine plus cognitive therapy) or medications alone and treated for up to a year until they are better. Medication treatment can involve up to four different classes of medications or medication combinations. Patients assigned to combined treatment will also meet with a cognitive therapist. The cognitive therapist will help patients identify beliefs that are unduly negative or pessimistic and teach them ways to evaluate the accuracy of those beliefs.

Once patients are better, they will continue to take whatever medications they took to get better (and continue meeting with their cognitive therapist if in the combined condition) until they have gone six months without getting depressed again. At that point, they will be asked to phase out of any ongoing cognitive therapy and randomly assigned to either stay on medications for another three years or to withdraw from medications. In either case, patients will be asked to continue to meet with their prescribing clinician on a regular basis (at least every three months) and followed closely by an independent clinical evaluator to determine whether they are starting to get depressed again. Anyone who has a recurrence of depression will be provided with additional treatment for the rest of the three-year follow-up period.

Additional information can be obtained by calling Linda Skaggs at (312) 980-6356.