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Fluoxetine plus cognitive behavioural therapy was most effective for adolescents with major depressive disorder

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Q In adolescents with major depressive disorder (MDD), how do fluoxetine, cognitive behavioural therapy (CBT), and their combination compare for effectiveness?


Embedded ImageDesign:

randomised controlled trial (RCT).

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded (patients and healthcare providers [fluoxetine v placebo comparison], and outcome assessors).

Embedded ImageFollow up period:

12 weeks.

Embedded ImageSetting:

outpatient clinic in the US.

Embedded ImagePatients:

439 adolescents (mean age 15 y, 54% girls) who had a DSM-IV diagnosis of MDD, could attend an outpatient clinic, scored ⩾45 on the Children’s Depression Rating Scale–Revised (CDRS–R), had a full scale IQ ⩾80, and were not taking antidepressants. Exclusion criteria included bipolar disorder, severe conduct disorder, substance abuse/dependence, 2 failed selective serotonin reuptake inhibitor (SSRI) trials, and poor response …

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  • * Information provided by author.

  • * Calculated from data in article.

  • For correspondence: Dr J S March, Department of Psychiatry, Duke University Medical Center, Durham, NC, USA.

  • Sources of funding: National Institute of Mental Health; fluoxetine and placebo supplied by Lilly Inc.