09-12-2022 | Brief Report
Antidepressant Medication Status as a Moderator of Winter Depression Recurrence Following Cognitive-Behavioral Therapy and Light Therapy: Is There Evidence of an Iatrogenic Effect?
Gepubliceerd in: Cognitive Therapy and Research | Uitgave 2/2023
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Hollon (Am Psychol 75(9):1207–1218, 2020) questioned whether antidepressant medication (ADM) has iatrogenic effects that prolong a depressive episode, contributing to relapse when ADM is stopped and explaining the apparent enduring advantage of cognitive-behavioral therapy (CBT) over ADM in reducing risk of recurrence. A randomized clinical trial including 177 adults with winter depression treated with 6 weeks of CBT or light therapy (LT) observed significantly fewer depression recurrences the second winter following CBT than LT, but not the first winter after treatment. Stable ADM use at baseline was allowed, with ADM status tracked at each followup. In logistic regression analyses, neither study treatment-baseline ADM status (CBT, CBT + ADM, LT, LT + ADM) nor ADM status at followup (present/absent) significantly predicted recurrence at either followup, and there were no significant interactions of these variables at either followup. After adjustment for ADM status at second winter, the likelihood of recurrence at second winter was (1) lower in CBT than in LT, among participants without and with baseline ADM (0.43X and 0.56X lower, respectively), and (2) not significantly different for those taking vs. not taking ADM at baseline in either CBT or LT. Results support an enduring effect of CBT, but not iatrogenic effects of ADM in this study.