Results One Year After Treatment With Drugs and/or Interpersonal Psychotherapy

\s=b\A one-year follow-up was conducted on ambulatory nonbipolar, nonpsychotic, acutely depressed patients who received amitriptyline hydrochloride and/or interpersonal psychotherapy (IPT), each alone and in combination, as part of a four-month clinical trial. There were no differential long-term effects of the initially randomized treatment on clinical symptoms one year later since most of the patients were asymptomatic. While most patients were functioning reasonably well, there were some main effects of IPT on social functioning at the one-year follow-up. Patients who received IPT with or without pharmacotherapy were doing significantly better on some measures of social functioning. (Arch Gen Psychiatry 38:51-55, 1981) A tricyclic antidepressant and some form of psychotherajt\. py, either alone or in combination, are the most common treatments in clinical practice for the outpatient depressive. Information is now available from welldesigned clinical trials on the short-term efficacy of these approaches either alone,1 in comparison,2 or in combina¬ tion.3" In general, these studies support the value of combining drugs and psychotherapy and demonstrate a differential response to the treatments.7 The next question in planning the care of depressed patients is how long the treatment effects last. Several clinical trials have included follow-up phases after the controlled treatment has ended, so that such information is now becoming available. This article reports the one-year follow-up results of a 16-week clinical trial of interpersonal psychotherapy (IPT) and amitripytline hydrochloride, each alone and in combi¬ nation, in a nonscheduled-treatment group and in acutely depressed, nonpsychotic, nonbipolar patients. The results of short-term treatment in this study showed the efficacy of both IPT and amitriptyline in overall symptom reduc¬ tion.5 Amitriptyline and IPT were about equally effective in symptom reduction, and the effects of both treatments in combination were additive. The additive effect of combined treatment was largely due to the differential effects of the two treatments. Amitriptyline mainly affected the vegetative symptoms of depression, such as sleep and appetite disturbance. The effect of psychothera¬ py was mainly on mood, apathy, suicidal ideation, work, and interest; it occurred slightly later (at four to eight weeks). There was no differential treatment effect on separate measures of social functioning during the 16 weeks of treatment. Here we report the clinical and social functioning of patients one year after the short-term treatment trial ended and examine long-term differential treatment effects.