The Role of Cognitive-Behavioral Therapy and Fluoxetine in Prevention of Recurrence of Major Depressive Disorder

This study evaluated the role of cognitive-behavioral therapy (CBT) and fluoxetine in preventing recurrence of a depressive episode during maintenance phase treatment for patients with remitted major depressive disorder (MDD). Patients (n = 52) completed open acute fluoxetine treatment and sustained remission during a 28-week randomized continuation treatment (CBT + fluoxetine vs. fluoxetine only). They were assigned to one of four maintenance treatments: CBT + fluoxetine, CBT + placebo, fluoxetine only, and placebo only. There were no statistically significant differences in MDD recurrence between maintenance treatments, but continued antidepressant treatment (with or without CBT) provided an 18–21% lower MDD recurrence rate than placebo. These findings are consistent with those of recent antidepressant studies of chronic and recurrent MDD populations. Although sample sizes were small, CBT did not significantly lower rates of MDD recurrence.