Controlled acute and follow-up trial of cognitive therapy and pharmacotherapy in out-patients with recurrent depression

Background We report a randomised controlled trial, in both the acute and maintenance stage of treatment, in 75 out-patients with recurrent major depression. Method Patients were allocated to three groups: 16 weeks of acute treatment and two years' maintenance treatment in the following way: antidepressants and maintenance antidepressants; cognitive therapy and maintenance cognitive therapy; antidepressants and maintenance cognitive therapy. Both completers' and end-point data were analysed. Results In the acute phase of treatment, all patients improved significantly and there was no significant difference among treatments, or in the pattern of improvement over time. In the maintenance stage of treatment, patients kept improving over time in all three groups and there was no significant difference among treatments. Cognitive therapy was consistently superior to medication. Conclusions The results indicate that maintenance cognitive therapy has a similar prophylactic effect to maintenance medication and is a viable option for maintenance after acute treatment with medication in recurrent depression.