Psychiatric Annals

Feature 

Combining Cognitive Therapy and Medication for Mood Disorders

Edward S. Friedman, MD; Jesse H. Wright, MD, PhD; Robin B. Jarrett, PhD; Michael E. Thase, MD

Abstract

Despite much intuitive support, the advantage of routinely combining an effective psychosocial intervention, such as cognitive therapy (CT), with medications for the treatment of mood disorders remains controversial. In this article, we first briefly summarize the research regarding the use of the combination of antidepressant medication and CT. Next, we describe the techniques used to combine these treatment modalities effectively — either concurrently or sequentially. Finally, we focus on the use of combination CT and medications to treat major depression in both the acute and continuation phases, as well as treatment-resistant depression and bipolar disorder.

ABOUT THE AUTHORS

Dr. Friedman is associate professor of psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA. Dr. Wright is professor and associate chairman, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY. Dr. Jarrett is professor of psychiatry and Elizabeth H. Penn Professorship in Clinical Psychology, Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX. Dr. Thase is professor of psychiatry, University of Pittsburgh Medical Center.

Address reprint requests to: Edward S. Friedman, MD, University of Pittsburgh Medical Center, 3811 O’Hara Street, BT 848, Pittsburgh, PA 15213; or e-mail friedmane@upmc.edu.

This research was supported in part by grants MH-71799, MH58356, and MH-69618 from the National Institute of Mental Health. Dr. Wright receives royalties from sales of a cognitive-behavior therapy computer program similar to those cited in the text. The authors disclosed no other relevant financial relationships.

Abstract

Despite much intuitive support, the advantage of routinely combining an effective psychosocial intervention, such as cognitive therapy (CT), with medications for the treatment of mood disorders remains controversial. In this article, we first briefly summarize the research regarding the use of the combination of antidepressant medication and CT. Next, we describe the techniques used to combine these treatment modalities effectively — either concurrently or sequentially. Finally, we focus on the use of combination CT and medications to treat major depression in both the acute and continuation phases, as well as treatment-resistant depression and bipolar disorder.

ABOUT THE AUTHORS

Dr. Friedman is associate professor of psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA. Dr. Wright is professor and associate chairman, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY. Dr. Jarrett is professor of psychiatry and Elizabeth H. Penn Professorship in Clinical Psychology, Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX. Dr. Thase is professor of psychiatry, University of Pittsburgh Medical Center.

Address reprint requests to: Edward S. Friedman, MD, University of Pittsburgh Medical Center, 3811 O’Hara Street, BT 848, Pittsburgh, PA 15213; or e-mail friedmane@upmc.edu.

This research was supported in part by grants MH-71799, MH58356, and MH-69618 from the National Institute of Mental Health. Dr. Wright receives royalties from sales of a cognitive-behavior therapy computer program similar to those cited in the text. The authors disclosed no other relevant financial relationships.

Despite much intuitive support, the advantage of routinely combining an effective psychosocial intervention, such as cognitive therapy (CT), with medications for the treatment of mood disorders remains controversial. In this article, we first briefly summarize the research regarding the use of the combination of antidepressant medication and CT. Next, we describe the techniques used to combine these treatment modalities effectively — either concurrently or sequentially. Finally, we focus on the use of combination CT and medications to treat major depression in both the acute and continuation phases, as well as treatment-resistant depression and bipolar disorder.

ABOUT THE AUTHORS

Dr. Friedman is associate professor of psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA. Dr. Wright is professor and associate chairman, Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY. Dr. Jarrett is professor of psychiatry and Elizabeth H. Penn Professorship in Clinical Psychology, Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, Dallas, TX. Dr. Thase is professor of psychiatry, University of Pittsburgh Medical Center.

Address reprint requests to: Edward S. Friedman, MD, University of Pittsburgh Medical Center, 3811 O’Hara Street, BT 848, Pittsburgh, PA 15213; or e-mail friedmane@upmc.edu.

This research was supported in part by grants MH-71799, MH58356, and MH-69618 from the National Institute of Mental Health. Dr. Wright receives royalties from sales of a cognitive-behavior therapy computer program similar to those cited in the text. The authors disclosed no other relevant financial relationships.

10.3928/00485713-20060501-01

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