Patients who undertake psychotherapy – also known as talking therapy – in addition to antidepressants, are twice as likely to become free from depression, the latest respected Cochrane research review has found.

Over one million people have been referred for talking therapy on the NHS through their GPs over the last decade.

However, this figure is dwarfed by the number of antidepressant prescriptions written in the same time-frame, which have doubled to around 70 million.

The study, overseen by the University of Bristol and the NHS' National Institute for Health Research, is timely.

Context

Earlier this year a separate research team reviewed data from 522 trials, involving 116,000 patients, and found that every one of the 21 antidepressants used was more effective than a placebo.

However, what was missed in most write-ups of that research, published in the Lancet, was that anti-depressants, while beneficial for many, have no impact on some who take them.

There remain lengthy waiting lists for talking therapies funded by the state, meaning people unable to fund their own psychotherapy are often only offered antidepressants by their GPs.

The Cochrane review of existing evidence aimed to establish the extent to which talking therapies work for people with treatment-resistant depression.

The research involved 698 people in total and studied three types of psychotherapy.

It has sometimes been lamented that there is no "psychotherapy placebo" to prove that it impacts depression.

The Cochrane review demonstrates that psychotherapy can often combat depression in cases when medication - or medication alone - does not. 

Response

“This is encouraging news for people with treatment-resistant depression," said Dr Nicola Wiles, who led the study.

"Because of the size and quality of the studies in our review, we can say that psychotherapy is an effective treatment when given in addition to medication for this patient group."

"This highlights how important it is to invest in psychological services, to reduce the significant burden to patients and healthcare systems associated with non-response to the most common treatment for depression."

“But there are still many unanswered questions. We don’t know if there are any differences in the effectiveness of different types of psychotherapy for this patient group, or if switching to a psychological treatment would be more beneficial than continuing medication alone. Future studies need to answer these important questions.”

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