Wednesday, October 23, 2013

Expert Discusses Treatment of Adolescents, Young Adults With Treatment-Resistant Depression

At a popular session yesterday at the 60th annual meeting of the American Academy of Child and Adolescent Psychiatry in Orlando, Fla., Karen Wagner, M.D., Ph.D., director of child and adolescent psychiatry at the University of Texas Medical Branch at Galveston, provided insights into the management of treatment-resistant depression in children based on her extensive research in this field.

Giving an overview of her work and that of other researchers, Wagner presented data involving the incorporation of cognitive-behavior therapy (CBT) with pharmacological agents in young adults with treatment-resistant depression. The data show that combining CBT with certain selective serotonin reuptake inhibitors can increase response rates by 10 percent or more, higher than medication therapy or CBT alone. Wagner also emphasized that the addition of CBT was twice as effective in depressed children who have been abused, compared with their counterparts who did not receiving CBT.

In addition, Wagner highlighted therapies that have recently been shown to be effective in treating young adults with treatment-resistant depression, including exercise, bright light treatment therapy, and video gaming.

Wagner urged using caution when prescribing medications that have not been thoroughly studied in children and adolescents, including vilazadone and ketamine. She advised clinicians to allow their patients, and parents of patients, to research the drugs that have been recommended prior to beginning treatment with them. “I do not give medication on the first day…I want them to read about the medication," said Wagner. She emphasized as well that it is “important to increase the knowledge about the role psychotherapy to improve the outcome in patients.”

For more information about adolescent depression, see the Psychiatric News article "Most Young Girls With Depression Fail to Receive Treatment". Also see the book Cognitive-Behavior Therapy for Children and Adolescents from American Psychiatric Publishing.

(image: Vabren Watts/Psychiatric News)


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