GPs should let depressed patients choose treatment method

Generic counselling is widely used as an alternative to antidepressants in patients with depression in primary care. However, the two treatments have not been directly compared. Chilvers et al (p 772) conducted a randomised controlled trial of antidepressants and counselling alongside a trial in which patients could choose their method of treatment. The two methods were equally effective at 12 months' follow up, although antidepressants worked more quickly. Most patients who had a choice opted for counselling, and these patients did better than those randomised to counselling. The authors conclude that patients with a strong preference should be allowed to have their choice of treatment.

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Relevant Article

Antidepressant drugs and generic counselling for treatment of major depression in primary care: randomised trial with patient preference arms

Clair Chilvers, Michael Dewey, Katherine Fielding, Virginia Gretton, Paul Miller, Ben Palmer, David Weller, Richard Churchill, Idris Williams, Navjot Bedi, Conor Duggan, Alan Lee, and Glynn Harrison
BMJ 2001 322: 772. [Abstract] [Full Text] [PDF]