This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Related articles  • Related letter  • Similar articles in this journal  Topic Collections  • Patient Safety/ Medical Error  • Patient-Physician Relationship, Other  • Pediatrics  • Adolescent Psychiatry  • Cognitive Therapy  • Depression  • Psychopharmacology  • Drug Therapy  • Suicide  • Adverse Effects  • Alert me on articles by topic

John S. March, MD, MPH; for the TADS Team

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In reply

We thank Dr Antonuccio for his comments on the TADS. Dr Antonuccio makes the point that the TADS treatments eventually converge and that medications come with greater risks than CBT at all points. On this basis, he argues that CBT alone may represent the best balance of benefit and risk, with combined treatment (COMB) a distant second choice if speed of response is a major consideration. While there is wisdom in what he says, the data and clinical realities tell a somewhat more subtle and complex story.

With respect to acute treatment, effect sizes at week 12 derived from the odds ratio for the dichotomized Clinical Global Impression–Improvement score are 0.84 for COMB, 0.58 for fluoxetine therapy, and 0.20 for CBT indicating that COMB works best for depression. Looking at all possible outcomes, not just depression, COMB has a . . . [Full Text of this Article]

AUTHOR INFORMATION

RELATED ARTICLES

The Treatment for Adolescents With Depression Study (TADS): Long-term Effectiveness and Safety Outcomes
The TADS Team
Arch Gen Psychiatry. 2007;64(10):1132-1143.
ABSTRACT | FULL TEXT  

Clinical Response and Risk for Reported Suicidal Ideation and Suicide Attempts in Pediatric Antidepressant Treatment: A Meta-analysis of Randomized Controlled Trials
Jeffrey A. Bridge, Satish Iyengar, Cheryl B. Salary, Rémy P. Barbe, Boris Birmaher, Harold Alan Pincus, Lulu Ren, and David A. Brent
JAMA. 2007;297(15):1683-1696.
ABSTRACT | FULL TEXT  

A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression
Carlos A. Zarate, Jr, Jaskaran B. Singh, Paul J. Carlson, Nancy E. Brutsche, Rezvan Ameli, David A. Luckenbaugh, Dennis S. Charney, and Husseini K. Manji
Arch Gen Psychiatry. 2006;63(8):856-864.
ABSTRACT | FULL TEXT  

Suicidality in Pediatric Patients Treated With Antidepressant Drugs
Tarek A. Hammad, Thomas Laughren, and Judith Racoosin
Arch Gen Psychiatry. 2006;63(3):332-339.
ABSTRACT | FULL TEXT  

Fluoxetine, Cognitive-Behavioral Therapy, and Their Combination for Adolescents With Depression: Treatment for Adolescents With Depression Study (TADS) Randomized Controlled Trial
Treatment for Adolescents With Depression Study Team
JAMA. 2004;292(7):807-820.
ABSTRACT | FULL TEXT  

RELATED LETTER

Tailoring Treatment to Parental Values: A Comment on TADS
David Antonuccio
Arch Gen Psychiatry. 2008;65(6):723.
EXTRACT | FULL TEXT