Question: In adults with depression, how effective is adding psychiatric medication to psychotherapy compared with psychotherapy alone for improving patient outcomes?

Answer:

No definite clinical implications can be made from the current evidence. The studies included in this BEST summary included patients with different severities of depression, and also evaluated different medications and types of psychotherapy, so that generalisations are difficult to make. One well conducted systematic review (which included studies evaluating any type of pharmacotherapy and any type of psychotherapy) reported that combined treatment was more effective than psychological treatment alone in the short-term. The authors also reported, however, that these results should be treated with caution.

None of the included studies made clear research recommendations. The authors of the systematic review stated that more long-term studies needed to evaluate the relative efficacy of psychological and combined treatments, and that more basic research is required to explore the mechanisms through which both treatments work.