Can Cognitive Behavioral Therapy for Anxiety and Depression Be Improved with Pharmacotherapy? A Meta-analysis

Psychiatr Clin North Am. 2017 Dec;40(4):715-738. doi: 10.1016/j.psc.2017.08.007. Epub 2017 Sep 18.

Abstract

The present meta-analysis examined controlled trials of pharmacologic augmentation of cognitive-behavioral therapy (CBT) for patients with anxiety or depressive disorders. The additive effect of medications was small for both anxiety and depressive disorders at posttreatment, and there was no additive benefit after medications were discontinued. A small body of evidence suggested that antidepressant medications are an efficacious second-line treatment for patients failing to respond to CBT alone. In anxiety disorders, novel agents thought to potentiate the biological mechanisms of CBT showed small effects at posttreatment; after discontinuation, some of these agents were associated with an increasing effect.

Keywords: Antidepressants; Anxiety disorders; Cognitive-behavioral therapy; Depression; Drug treatment.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Anti-Anxiety Agents / pharmacology*
  • Antidepressive Agents / pharmacology*
  • Anxiety Disorders / drug therapy
  • Anxiety Disorders / therapy*
  • Cognitive Behavioral Therapy / methods*
  • Combined Modality Therapy / methods*
  • Depressive Disorder / drug therapy
  • Depressive Disorder / therapy*
  • Humans
  • Outcome Assessment, Health Care / statistics & numerical data*

Substances

  • Anti-Anxiety Agents
  • Antidepressive Agents