Sarah Goodwin

Kathi Ovnic
Holly Korschun
May 18, 1999

CHRONIC DEPRESSION: Study of Antidepressant (nefazodone HCI) plus Talk Therapy Show Highest Rates Ever of Response and Remission

WASHINGTON, D.C. -- Drug therapy with the antidepressant nefazodone HCI combined with a certain kind of talk therapy offer relief from chronic depression much more effectively than either therapy alone, report researchers at this week's American Psychiatric Association meeting.

Eight-five percent of 681 adults with chronic depression (lasting two years or longer) responded to the dual treatment versus 55 percent of subjects taking Serzone® (the brand name under which nefazodone HCI is prescribed) alone or 52 percent receiving psychotherapy alone. These preliminary study findings are the highest response and remission rates for any reported study of chronic depression, the researchers say.

Researchers at Emory University were among those at 12 medical centers involved in the landmark, Serzone® Chronic Depression Study, led by the Brown University School of Medicine and funded by Bristol-Myers Squibb Company, makers of Serzone. Data reported this week come from the acute phase of the study.

"Though study results cannot be extrapolated to other antidepressants or other, less structured forms of psychotherapy, the Serzone Chronic Depression Study should put to rest the widespread believe that chronic depression is resistant to drug treatment and psychotherapy," says Emory study investigator Philip T. Ninan, M.D., associate professor and director of the Mood and Anxiety Disorders Program, department of psychiatry and behavioral sciences, Emory University School of Medicine.

Fifty-seven patients were enrolled in the Emory arm of the national trial by Dr. Ninan and Emory psychiatry colleagues Charles B. Nemeroff, M.D., Ph.D., department chairman and Jeffrey Kelsey, M.D., Ph.D., assistant professor.

Nefazodone is known as a selective receptor antagonist. In the current study, it was well tolerated and provided significant early relief of insomnia compared to psychotherapy alone, according to the researchers.

"The extremely large difference in response rates after 12 weeks truly astonishing," says Martin B. Keller, M.D., lead researcher of the study, and professor and chairman of the department of psychiatry and human behavior at Brown.

"The next step is to translate the acute phase findings into appropriate treatment guidelines for initial management of chronic depression. The data that will emerge from the continuation and maintenance phases (of the 80-week study) will be extremely helpful in developing long-term treatment guidelines for managing patients with chronic depression."

The psychotherapy used in the study is a structured, intensive program developed specifically to treat chronic depression called Cognitive Behavioral Analysis System of Psychotherapy (CBASP).


More than 46 million Americans (ages 15-34) suffer from depressive episodes annually, and approximately one-third, or 14 million, or this group suffer from chronic depression. Recent reports indicate depression costs the U.S. economy an estimated

$53 billion annually. The highest rates of depression occur among adults ages 25-44.

In any six-month period, 6.6 percent of women and 3.5 percent will have depressive disorder. For women, depression is most likely to first appear between the ages of 15 and 19; for men between the ages of 25 and 29. Women are at higher risk for the depression than men.

The Global Burden of Disease Study (Murray Ga, Lopez AD, 1996) identifies depression as a leading cause of worldwide disability, ranking above heart attacks, stroke and diabetes. Factors contributing to the global level of disability associated with depression are high prevalence, increased rates of recurrence, chronicity and associated medical and psychiatry comorbidity.

Chronic depression is an episode of major depression that persists more than two years.

Chronic depression is a debilitating and often life-threatening disorder. Achieving recovery and preventing relapse or recurrence are essential for the long-term well being of the depressed patient. Studies show that depression treatment requires long-term, skillful followup and active use of antidepressant medication.

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