October 11, 2007 - By combining medication with talk therapy, four in five adolescents are completely recovering from major depressive disorder. The Treatment for Adolescents with Depression Study found that while adolescents who take antidepressants show improvement significantly earlier, without talk therapy, these teens have more sudden urges to commit suicide.

In the past, findings about the negative effects of antidepressants like Prozac or Paxil on adolescents made doctors leery of prescribing them to teens. Specifically, it was discovered that Prozac could increase the number of suicidal thoughts teens experienced. The new study followed 654 adolescents being treated for chronic depression and found that 80 percent recovered either entirely or almost entirely when treated over nine months with medication, talk therapy, or a combination of the two. Patients taking medication showed significant signs of improvement sooner than those who received talk therapy alone, but were about twice as likely to report feeling suddenly suicidal. The combination of the two therapies, the authors found, produced the most rapid recovery and protected against sudden suicidal urges. Talk therapy also promotes positive behaviors and thoughts that combat suicidal feelings. This alone can prevent adolescents from relapsing into depression.

The National Academies have a number of studies that examined depression and suicide in adolescents. A Study of Interactions: Emerging Issues in the Science of Adolescence, the summary of an Academies workshop, includes a brief review of key factors impacting depression in adolescence, interventions and treatments that are currently available, and future directions for research, treatment, and prevention. Reducing Suicide: A National Imperative found that prevention programs that combine treatments such as therapy through medicine and psychology can be effective in preventing suicide. The report provides a blueprint for addressing this national problem through an appropriate infrastructure, needed research, and improved interventions.

• A Study of Interactions: Emerging Issues in the Science of Adolescence
• Reducing Suicide: A National Imperative

• National Institute of Mental Health