Systematic review of the efficacy of pharmacological treatment alone vs. psychotherapy alone or the combination of both in the treatment of depressive disorders

Depression is a challenging condition to treat especially where the efficacy of the current types of treatments has been in debate for decades. The aim of this review was to compare the effectiveness of medications to psychotherapy interventions and the combination of both interventions in the treatment of depression. This was conducted by evaluating the evidence from studies that investigated the efficacy of alone interventions and dual therapy to identify the best course of treatment for depression. Twenty studies were selected of which ten were directly compared pharmacotherapy with psychotherapy and a further ten compared the combination of both to either of the two monotherapies. The results showed that in either of monotherapies cohorts, the rates of response, remission and changes in symptom severity were near equivalent for both but dropout rates were higher for the medications groups. Comparing dual therapy to the monotherapies showed higher efficacy in terms of response, remission and reduction of symptom severity for combination. The difference however seen less with pharmacotherapy and showed psychotherapy being least effective but the difference was in efficacy is small in the majority of the studies, to a point in which the question of‘is the difference clinically significant’ remained unanswered which require more definitive future research