Preventive Cognitive Therapy prevents recurrence of depression : Lancet

Preventive cognitive therapy (PCT) has been proposed as an alternative to maintenance antidepressant treatment in Patients in remission but whether its addition would allow tapering of antidepressants or enhance the efficacy of maintenance antidepressant treatment is unclear.Prof Claudi L H Bockting, Ph.D. and colleagues conducted a three-group, multicentre, randomised controlled trial to compare the effectiveness of antidepressants alone, with PCT while tapering off antidepressants, or PCT added to antidepressants in the prevention of relapse and recurrence. The researchers found that cognitive therapy can help prevent recurrence in those who continue antidepressants and those who taper off them in patients in remission from depression.The study has been published in Lancet Psychiatry.

Nearly 300 patients with a history of depressive episodes who were in remission while taking antidepressants and had a high risk for recurrence were randomized to one of three groups: 8 weekly sessions of preventive cognitive therapy (which is different from cognitive behavioral therapy) plus continued antidepressants, preventive cognitive therapy while tapering off antidepressants, or antidepressants alone. At enrollment, participants had to be in remission for at least 8 weeks but not more than 2 years.

After 2 years' follow-up, the estimated cumulative recurrence rate was significantly lower in the cognitive therapy plus continued antidepressants group (43%) than in the other two groups (roughly 60%). Of note, antidepressants alone were not superior to cognitive therapy plus antidepressant tapering.

The researchers conclude that preventive cognitive therapy "should be offered to recurrently depressed individuals on antidepressants and to individuals who wish to stop antidepressants after recovery."