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A new combination of drug treatment and psychotherapy is much more effective than either medication or therapy alone for treating chronic depression, according to preliminary results presented today at the 1999 annual meeting of the American Psychiatric Association.

The study was conducted jointly by researchers from 12 academic medical centers nationwide. James H. Kocsis, M.D., Professor of Psychiatry and John C. Markowitz, M.D., Associate Professor of Clinical Psychiatry, are the principal investigators of the study at New York Weill Cornell Center of New York Presbyterian Hospital.

The combination treatment, involving the drug nefazodone and a form of psychotherapy developed specifically to treat chronic depression, also produced the highest response and remission rates for any reported study of chronic depression.

The findings come from the Serzone Chronic Depression Study, the first major study of medication alone, psychotherapy alone, and the combination of both in patients with chronic depression. Nefazodone, prescribed under the brand name Serzone™, is used to treat depression and is effective for reducing relapse.

Results from the acute phase—the first 12 weeks—of the 80-week study of 681 patients depressed for at least two years show that a combination of nefazodone and psychotherapy produces an 85 percent response rate. The drug alone leads to a 55 percent rate of response, similar to 52 percent response rate for psychotherapy.

"This study should put to rest the widespread belief that chronic depression is resistant to drug treatments and psychotherapy," said Dr. Kocsis. "It should offer great hope for recovery for patients suffering from chronic depression because this study demonstrates that an extremely high proportion of patients can be effectively treated with Serzone and psychotherapy specifically developed to treat chronic depression."

The research includes a 16-week continuation trial for patients who respond positively to nefazodone or to the combination treatment in the acute phase followed by a 52-week maintenance treatment to evaluate the drug versus a placebo.

About 14 million Americans suffer from chronic forms of depression, marked by disabling psychological and social problems. These individuals are often misdiagnosed as having character and personality disorders.

"The next step is to translate the acute phase findings into appropriate treatment guidelines for initial management of chronic depression," commented Dr. Kocsis. "We have a very stong evidence that a structured, cognitive-based therapy is very effective. We hope this will lead to more chronically depressed people receiving these treatments so response rates will be higher."