Interpersonal Psychotherapy and Antidepressant Medication: Evaluation of a Sequential Treatment Strategy in Women With Recurrent Major Depression
J Clin Psychiatry 2000;61:51-57
© Copyright 2014 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Few data are available to guide
treatment selection in major depression. With increasing pressure
to maximize the efficiency and minimize the costs of treatment,
it is important to have information that could guide treatment
selection or point to treatment strategies that have a high
probability of success.
Method: We used a successive cohort approach to
compare 2 highly similar groups of women with recurrent unipolar
disorder (DSM-III-R or DSM-IV): one in which the combination of
interpersonal psychotherapy (IPT) and pharmacotherapy was
initiated at the outset of treatment and a second in which IPT
alone was provided first and only those who did not remit with
IPT alone were offered the combination treatment.
Results: In the group in which the combination
was initiated at the outset of treatment (N = 180), the remission
rate was 66%, comparable to the remission rate observed in most
outpatient treatment studies of major depression. In contrast,
among the women in the second cohort who were first treated with
IPT alone and only those who did not remit were given combination
therapy (N = 159), the remission rate was 79%, significantly
greater than that observed in the group that received combination
treatment from the outset (chi2 = 6.55, p = .02).
Conclusion: These results suggest that the
strategy of offering IPT to women with recurrent unipolar
disorder and, in the absence of remission, adding antidepressant
pharmacotherapy can be a highly effective treatment, one that may
be particularly attractive to women in the childbearing years.
Although slower in its onset of action, this sequential strategy
is likely to enable the clear majority of such women to achieve a
full remission of depressive symptoms.