Section - Quick Takes

03. Initial Treatment Choices to Achieve Sustained Response in Major Depression: A Systematic Review and Network Meta-Analysis

Published on April 1, 2022 Expired on April 1, 2024

James Phelps, M.D.

Research Editor - Psychopharmacology Institute

Key Points

In a network meta-analysis of studies examining long-term response to initial treatment for major depression:

The combination of medications and psychotherapy was superior to either alone, if both modalites were continued after initial improvement.
Psychotherapy alone was superior to medications alone, when compared with the outcomes of standard care.
The latter conclusion may be significantly limited by lack of blinding of psychotherapy studies compared with pharmaceutical studies.

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Text version

Do you get to see patients with their first episode of depression, meaning treatment-naïve patients who’ve never had an antidepressant or psychotherapy? I hope you get those once in a while. When you do, there are 3 main treatment options—medications, psychotherapy, or their combination. Which works best not just for getting well but for staying well?

Hi! Jim Phelps here for the Psychopharmacology Institute. A new meta-analysis speaks directly to that question. The investigators winnowed 89,000 articles to find 81 studies that reported maintenance phase data after acute treatment—or in other words, staying well. Initial treatment could be psychotherapy, medications, or both, and the maintenance phase could be any of these or naturalistic, meaning participants were free to pursue any treatment or no treatment and then were contacted later for a follow-up mood assessment.

Six different combinations are thus possible. Acute treatment with combined medications and therapy could be followed

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04. Adjunctive Ketamine With Relapse Prevention-Based Psychological Therapy in the Treatment of Alcohol Use Disorder

Learning Objectives:

After completing this activity, the learner will be able to:

Examine adverse drug reactions to psychiatric medications in small and large databases from around the world.
Assess the efficacy of transcranial magnetic stimulation for smoking cessation in a large randomized trial.
Compare the outcomes of multiple studies of initial treatments for major depressive disorder in a network meta-analysis of pharmacotherapy, psychotherapy, and their combination in acute and maintenance treatment.
Evaluate the relative effectiveness of ketamine and placebo when combined with either mindfulness psychotherapy or psychoeducation for the treatment of alcohol use disorder.
Consider the channels through which antidepressants cause manic switches in susceptible individuals.

Original Release Date: April 1, 2022

Review Date: March 1, 2024

Expiration Date: April 1, 2024

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:

Participants must complete the activity online during the valid credit period that is noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.