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Segal 2010 Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy


Phil
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I thought this might be worth posting:

 

http://www.ncbi.nlm.nih.gov/pubmed/21135325

 

CONCLUSIONS:

 

For depressed patients achieving stable or unstable clinical remission, MBCT offers protection against relapse/recurrence on a par with that of maintenance antidepressant pharmacotherapy. Our data also highlight the importance of maintaining at least 1 long-term active treatment in unstable remitters.

Nice to know that mindfulness has as good effects as AD's! If only more people knew. I wish everyone who believes that meds are the only way could read this.

Off Lexapro since 3rd November 2011.

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Arch Gen Psychiatry. 2010 Dec;67(12):1256-64.

Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression.

Segal ZV, Bieling P, Young T, MacQueen G, Cooke R, Martin L, Bloch R, Levitan RD.

 

Source

 

Centre for Addiction and Mental Health, Toronto, ON, Canada. zindel_segal@camh.net

Abstract at http://www.ncbi.nlm.nih.gov/pubmed/21135325

 

CONTEXT:

 

Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse.

 

OBJECTIVE:

 

To compare rates of relapse in depressed patients in remission receiving MBCT against maintenance antidepressant pharmacotherapy, the current standard of care.

 

DESIGN:

 

Patients who met remission criteria after 8 months of algorithm-informed antidepressant treatment were randomized to receive maintenance antidepressant medication, MBCT, or placebo and were followed up for 18 months.

 

SETTING:

 

Outpatient clinics at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and St Joseph's Healthcare, Hamilton, Ontario.

 

PARTICIPANTS:

 

One hundred sixty patients aged 18 to 65 years meeting DSM-IV criteria for major depressive disorder with a minimum of 2 past episodes. Of these, 84 achieved remission (52.5%) and were assigned to 1 of the 3 study conditions.

 

INTERVENTIONS:

 

Patients in remission discontinued their antidepressants and attended 8 weekly group sessions of MBCT, continued taking their therapeutic dose of antidepressant medication, or discontinued active medication and were switched to placebo.

 

MAIN OUTCOME MEASURE:

 

Relapse was defined as a return, for at least 2 weeks, of symptoms sufficient to meet the criteria for major depression on module A of the Structured Clinical Interview for DSM-IV.

 

RESULTS:

 

Intention-to-treat analyses showed a significant interaction between the quality of acute-phase remission and subsequent prevention of relapse in randomized patients (P = .03). Among unstable remitters (1 or more Hamilton Rating Scale for Depression score >7 during remission), patients in both MBCT and maintenance treatment showed a 73% decrease in hazard compared with placebo (P = .03), whereas for stable remitters (all Hamilton Rating Scale for Depression scores ≤7 during remission) there were no group differences in survival.

 

CONCLUSIONS:

 

For depressed patients achieving stable or unstable clinical remission, MBCT offers protection against relapse/recurrence on a par with that of maintenance antidepressant pharmacotherapy. Our data also highlight the importance of maintaining at least 1 long-term active treatment in unstable remitters.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Excellent find, Phil. The more documentation we have on this, the better.

 

There is another way!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I came across another article on there which said that, rates of relapse following discontinuation of AD's + MBCT was equal to just taking an AD. Of course, I suppose they don't regard the "relapse" as connected to withdrawal syndrome.

 

I'll post if I find it!

Off Lexapro since 3rd November 2011.

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