Teen depression can hurt school performance, relationships with family and friends, and even lead to suicide.
A new study in JAMA, the Journal of the American Medical Association, compared depression treatment methods in teens.
Dr. John March/Duke University Medical Center: "We also wanted to see if there was advantage to combining the treatments over using the individual treatments alone."
Dr. John March at Duke University Medical Center is part a group of psychiatrists and psychologists who designed the "Treatment for Adolescents with Depression Study."
The researchers enrolled 439 moderately to severely depressed teens at thirteen sites across the country. Some of the teens were treated with the anti-depressant fluoxetine some were treated with counseling called Cognitive Behavioral Therapy, or CBT.
Some received a combination of fluoxetine and CBT, and some got placebo, or sugar pill. After 12 weeks of treatment, here's what the researchers found.
Dr. John March/Duke University Medical Center: "The combination of the two treatments, fluoxetine and cognitive behavioral psychotherapy, has a significant advantage."
About 70 percent of kids receiving combination therapy responded to treatment. About 40 percent of teens receiving counseling alone responded. 35 percent of teens on placebo saw improvement. About 60 percent of teens taking fluoxetine alone responded close to the response rate of those receiving combined therapy. But there was an important difference.
Dr. John March/Duke University Medical Center: "There seems to be an increased risk of doing something harmful to yourself if you're treated with medication as compared to being treated with CBT."
In other words, fluoxetine did improve depression, but kids taking it still had a slightly higher risk of self-harm. CBT, or counseling, seems to mitigate that risk.
Dr. John March/Duke University Medical Center: "The treatments target different things. It's likely that fluoextine targets the broad domain of regulation of mood and feelings, whereas CBT targets specific domains like suicidal thinking or family conflict."