Preventive cognitive therapy could be a viable and effective addition to antidepressant medication in preventing relapse or recurrence in major depressive disorder

Commentary on: Bockting CLH, Klein NS, Elgersma HJ, et al. Effectiveness of preventive cognitive therapy while tapering antidepressants versus maintenance antidepressant treatment versus their combination in prevention of depressive relapse or recurrence (DRD study): a three-group, multicentre, randomised controlled trial. Lancet Psychiatry . 2018; 5:401-410. Many patients with major depressive disorder (MDD) are treated with maintenance antidepressant medication (mADM) to prevent relapse and recurrence. There is increasing evidence that psychological interventions may be at least as effective in terms of relapse prevention in recurrent MDD.1 However, discontinuing mADM has been demonstrated as potentially difficult and associated with increased relapse risk.2 The current study3 was a three-group, multicentre, single-blind, parallel, randomised controlled trial(supplementary file 1). Patients with recurrent MDD in remission (n=289) were recruited in the Netherlands between 2009 and 2015, via general practitioners (GP), pharmacists, specialised mental healthcare centres and the media, and randomly allocated (10:10:8) to receive either preventive cognitive therapy (PCT) plus mADM (n=104), mADM alone (n=100) or PCT with tapering of mADM (n=85). ### Supplementary file 1 [SP1.pdf] PCT consisted of …