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February 15, 2016

Cognitive behavioral therapy similarly effective to antidepressants, new guidelines say

American College of Physicians releases new guidelines on treating depression

Cognitive behavioral therapy and antidepressant drugs are the top recommendations for treating depression in adults, according to a new set of guidelines published by the American College of Physicians in Philadelphia.

Researchers reviewed dozens of studies published in the past 35 years to find which treatments are supported by the highest-quality evidence, namely randomized, controlled trials. They investigated not only conventional treatments but alternative medicine as well, from acupuncture to St. John's wort.

The College's highest grades went to cognitive behavioral therapy (CBT) and second-generation antidepressants (SGAs), finding that these treatments had the most scientific evidence to back them up.

Under CBT, a therapist literally teaches his or her client how to think. The client learns how to identify negative mental patterns, like always blaming yourself when things go wrong, and change them.

As the National Association of Cognitive-Behavioral Therapists described it:

"Cognitive-behavioral therapy is based on the idea that our thoughts cause our feelings and behaviors, not external things, like people, situations and events.  The benefit of this fact is that we can change the way we think to feel/act better even if the situation does not change."

The guidelines did not say that CBT is better or worse than antidepressant drugs, only that they are "similarly effective." However, the report did suggest that doctors should "strongly consider" therapy before prescribing drugs.

"Although SGAs are often initially prescribed for patients with depression, CBT is a reasonable approach for initial treatment and should be strongly considered as an alternative treatment to SGAs when available," the report said.

Read the guidelines, published in the Annals of Internal Medicine, here.

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