Depressed patients should be allowed to choose their treatment

March 29, 2001

Antidepressant drugs and generic counselling for treatment of major depression in primary care: randomised trial with patient preference arms

Editorial: Managing depression in primary care

Generic counselling appears to be as effective as antidepressant drugs for major depression, although patients given drugs may recover more quickly, according to a study in this week's BMJ.

The findings also shows that, given a choice, patients who opt for counselling may benefit more than those with no strong preference and therefore GPs should allow patients to have their preferred treatment.

Over 100 depressed patients were randomly allocated either antidepressants or counselling and a further 220 patients were given their choice of treatment. After 12 months, the two methods were equally effective, although patients treated with antidepressants recovered more quickly than those receiving counselling did. Most patients who were given a choice opted for counselling, and these patients did better than those randomised to counselling.

Despite some study limitations, the authors recommend that general practitioners should allow patients to have their choice of treatment.

Dr Richard Churchill, University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK Email:


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