Specialists challenge claim that fluoxetine plus talk therapy works best for depressed adolescents

A US study of clinically depressed adolescents, showing that a combination of fluoxetine (Prozac) and cognitive behaviour therapy (CBT) works best, has sparked concerns over the interpretation of the data.

The multicentre trial randomised 439 depressed adolescents aged 12-17 years to four arms: fluoxetine alone, CBT alone, CBT plus fluoxetine, or placebo. The results showed that at 12 weeks, 71% of those treated with CBT plus fluoxetine had improved, compared with just over 60% of those taking fluoxetine alone, 43% treated with CBT alone, and 35% taking placebo alone (JAMA 2004;292: 807-20).

Fluoxetine is the only anti-depressant …