Combining Cognitive Therapy and Pharmacotherapy for Depressive Disorders: A Review of Recent Developments

Cognitive Behavior Therapy (CBT) and pharmacotherapy, including antidepressants for depressive disorders and mood stabilizers for bipolar disorders, are effective and widely disseminated treatments that often are considered the first line of therapy for these common, yet potentially disabling conditions. Given the imperfect and often unpredictable effects of these treatments, as well as the obvious differences in the aspects of depressive syndromes that they target, there has been a longstanding and widespread belief that these strategies will have additive effects. After 30-plus years of research-and slow progress-it now seems reasonably clear that CBT and pharmacotherapy have a partially additive benefit for patients with depressive disorders; this effect is proposed to be largely explained by improving outcomes for patients who are less responsive to one or both of the monotherapies. This article summarizes the research literature, including newer studies that examining differential impact on neural circuits and the metabolic activity of relevant brain regions.