Bipolar Support Groups.com blog

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Risk factors are often confused with warning signs of suicide, and frequently suicide prevention materials mix the two into lists of “what to watch out for.” It is important to note, however, that factors identified as increasing risk are not factors that cause or predict a suicide attempt. Risk factors are characteristics that make it more likely that an individual will consider, attempt, or die by suicide. Protective factors are characteristics that make it less likely that individuals will consider, attempt, or die by suicide.
Risk Factors for Suicide
•Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders and certain personality disorders
•Alcohol and other substance use disorders
•Hopelessness
•Impulsive and/or aggressive tendencies
•History of trauma or abuse
•Major physical illnesses
•Previous suicide attempt
•Family history of suicide
•Job or financial loss
•Loss of relationship
•Easy access to lethal means
•Local clusters of suicide
•Lack of social support and sense of isolation
•Stigma associated with asking for help
•Lack of health care, especially mental health and substance abuse treatment
•Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
•Exposure to others who have died by suicide (in real life or via the media and Internet)
Protective Factors for Suicide
•Effective clinical care for mental, physical and substance use disorders
•Easy access to a variety of clinical interventions
•Restricted access to highly lethal means of suicide
•Strong connections to family and community support
•Support through ongoing medical and mental health care relationships
•Skills in problem solving, conflict resolution and handling problems in a non-violent way
•Cultural and religious beliefs that discourage suicide and support self-preservation
(This was adapted from “Understanding Risk and Protective Factors for Suicide” and “Risk and protective factors for suicide” by the Suicide Prevention Resource Center.)

Company

Address
Medical Information
Abbott Laboratories
100 Abbot Park Rd.
Abbott Park, IL 60064
800-633-9110

AstraZeneca Pharmaceuticals
PO Box 15437, DE 19850
800-236-9933

Barr Laboratories
Customer Service
400 Chestnut Ridge Rd Woodcliff Lake, NJ 07677
800-227-7522

Boehringer Ingelheim Pharmaceuticals, Inc.
900 Ridgebury Rd.
PO Box 368
Ridgefield, CT 06877-0368
800-542-6257

Bristol-Myers Squibb, Co.
PO Box 4500
Princeton, NJ 08543-4500
800-321-1335

Eli Lilly and Company
Lilly Corporate Center
Indianapolis, IN 46285
800-545-5979

Forest Pharmaceuticals, Inc.
13600 Shoreline Drive St. Louis, MO 63045
800-678-1605

GlaxoSmithKline
One Franklin Plaza
PO Box 7929
Philadelphia, PA 19101
888-825-5249

Ivax Pharmaceuticals
Customer Service
4400 Biscayne Blvd. Miami, Florida 33137
800-327-4114

Janssen Pharmaceutica, Inc.
1125 Trenton-Harbourton Rd.
PO Box 200
Titusville, NJ 08560-0200
800-526-7736

McNeil Consumer & Specialty Products
Consumer Relations Center
7050 Camp Hill Rd
Fort Washington, PA 19034-2210
800-962-5357

Novartis Pharmaceuticals Corp.
59 Route 10
East Hanover, NJ 07936
800-245-5356

Ortho-McNeil-Janssen Pharmaceuticals, Inc.
1125 Trenton-Harbourton Rd.
PO Box 200
Titusville, NJ 08560-0200
800-526-7736

Pfizer, Inc.
235 East 42nd St.
New York, NY 10017-5755
800-438-1985

Roche Pharmaceuticals
340 Kingsland St.
Nutley, NJ 07110-1199
800-526-6367

Sanofi-Aventis
55 Corporate Drive
Bridgewater, NJ 08807
800-207-8049

Schering Plough Corporation
Consumer Relations
PO Box 377
Memphis, TN 38151-0001
800-842-4090

Solvay Pharmaceuticals, Inc.
901 Sawyer Rd.
Marietta, GA 30062
800-354-0026

Sunovion Pharmaceuticals, Inc.
84 Waterford Drive
Marlborough, MA 01752
800-739-0565

Wyeth
PO Box 8299
Philadelphia, PA 19101
800-934-5556

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Long term monitoring is valuable in monitoring is valuable in Bipolar Disorder to faciliate recognition of the vairiablity in the mood swings associated with the condition, including identification of symptom-free intervals.
Ongoing monitoring also provides an “early warning” system and a method to recognize any patterns of stressful life events that ,ay act as triggers.
Detailed documentation of medication and triggers provides information about adherence and the relationship of the medication and trigger type and schedule to the mood swings.
MOOD CHARTS:

Mood charting is a simplified patient self-report technique derived from the more extensive Life Chart approach. The participation of the patient in providing input to the daily documentation has been found to promote a more involved an d collaborative theraputic alliance with the clinician.
Patient participation serves to reinforce education and information about the condition and how to manage life style
(sleep habits, etc) and promotes active involvement in the management of the disorder

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DSM-V New Revised EDITION “

“These changes that are going to happen by May, 2013′ are going to surprise you” Published ”Scientific American Mind”
Written by: Ferris Jabr:
The DSM ( Diagnostic and Statistical Manual of Mental Disorders ), has not been up dated for 30 years now. These changes just might surprise you. Stated on the cover of this Article “Redefining Mental Illness.” In 2010′ American Psychiatric Association debuted a draft of the new manual on their Web Site that has so far received 50 million hits from about 500,000 individuals, many of them critics.
The revised manual will very likely scrap Psychiatry staples such as “Asperger’s syndrome and paranoid personality disorder.
Additions to the diagnostic manual are likely to include an ailment for children marked by severe temper tantrums and for adults a type of sex addiction.
The DSM-5 framers are scrapping certain disorders, such as Asperger’s and adding brand – new ones including addiction to gambling.
Psychiatrists have long come under fire for over diagnosing certain aliments, especially in children, and doing out medications as freely as lollipops. Giving childhood Bipolar Disorder a new name and defining a syndrome of early psychosis may only intensify the problem.
To make its new diagnostic manual easier to use, the American Psychiatric Association organized the book’s contents chronologically, starting with diseases that most often appear in childhood and covering adult disorders toward the back.
Curators of the new book eliminated over a dozen less distinct disorders, sometimes merging them into larger categories.
Experts traditionally reserved the term “addiction” for drug related problems. Now they are recognizing other types of addictive behaviors. Food, sex, and gambling addictions are likely to make their debut in the latest edition of psychiatry’s diagnostic bible.
“The DSM has always been a primitive guide to the world of Psychological stress, but the categories have become more reliable and meaningful.”

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How can I get information about medications?

Many mental health consumers, as well as concerned family and friends, seek information to help them better understand the benefits of prescribed medications, potential side effects, and to help them in talking with their doctor about such matters.
Mental Health America encourages consumers to talk with their doctor regarding any medication-related questions or concerns and to inform him or her about all the medications being taken so that negative drug interactions can be avoided.
In addition to talking with their doctor, many consumers and their family members want to consult other information sources.
Medication Decisions

When you’re feeling overwhelmed or confused, it’s understandable that you might want to let others make medication decisions for you. But it’s becoming clearer to researchers, providers and mental health consumers themselves that being actively involved in your treatment can make a real difference in your recovery. Talking honestly with your doctor is a big part of that process. If you discuss your concerns and learn about your options, you are much more likely to come up with a plan that works well for you and for the life you want to create.
The following tips can help you decide about taking a medication:•Get information. Ask your provider how the medication is supposed to help with your specific concerns. Also find out about any possible side effects. You might consider taking notes, since it can be hard to remember a lot of information, especially when you aren’t feeling well. You also might ask a friend or relative to go with you for emotional support and to help keep track of important information. Use MHA’s Antipsychotic Medication Checklist to help with such discussions.
•Talk with others with similar experiences. Self-help groups and peer specialists-people with mental health conditions who are trained to help-can provide great first-hand information. Remember that every person is different, but you can learn from the experiences of others.
•Think about your priorities and goals. Is relief from symptoms extremely important? If not, maybe you’re willing to live with some symptoms to avoid side effects. What are your main life goals? How might medication help?
•Sometimes the only way to know if a medication is right for you is to try it. You may find that it helps you feel much better. If not, you can decide to stop later.
What should I ask about the medications that are prescribed for me?

The U.S. Food and Drug Administration (FDA) recommends that you ask the following questions:•What is the name of the medication and what is it supposed to do?
•How and when do I take it, and when do I stop taking it?
•What foods, drinks or other medications should I avoid while taking this medication?
•Should it be taken with food or on an empty stomach?
•Is it safe to drink alcohol while on this medication?
•What are the side effects, and what should I do if they occur?
•Is a Patient Package Insert for the medication available?
How can I tell if my medication is working?

Some people get relief from their symptoms immediately, others after a few days or weeks; for others, it may take even longer. After a short time on the medication, it’s important to share with your doctor or therapist how you are doing with the treatment. Together, you may need to find the right amount of medicine or combination of medicines.
It’s especially important to tell your doctor about any side effects you’re having from the medication. You may be able to make some changes in dosage or the time of day you take the medication to lessen or get rid of the side effects. There are also newer medications that have fewer side effects than older drugs, making it easier for people to stay on them. If after an extended period of time on a medication you are still not experiencing progress, you may need to talk with your doctor about trying another medication. Consult your doctor before making any changes in your medication.
How long you take medication really depends on your particular needs. Some people are able to discontinue medication when their symptoms have fully subsided and they have reached their treatment goals. Others may need to remain on medication for longer periods of time as part of a long-term recovery plan.
To talk with a knowledgeable professional, you can consult the following resources:
•Your local pharmacist is a valuable resource to answer medication-related questions. Pharmacies are required to provide written information about prescriptions they are dispensing.
•Pharmaceutical companies have staff that can respond to questions from the general public. View pharmaceutical company medical information telephone numbers below.
•In addition, many states have Drug Information Centers operated by area hospitals

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“9 WAYS TO HELP A SUICIDAL FRIEND:”

Take it seriously.

1.Myth: The people who talk about it don’t do it. Studies have found that more than 75% of all completed suicides did things in the few weeks or months prior to their deaths to indicate to others that they were in deep despair. Anyone expressing suicidal feelings needs immediate attention.
Myth: Anyone who tries to kill himself has got to be crazy. Perhaps 10% of all suicidal people are psychotic or have delusional beliefs about reality. Most suicidal people suffer from the recognized mental illness of depression; but many depressed people adequately manage their daily affairs. The absence of craziness does not mean the absence of suicide risk.
Those problems weren’t enough to commit suicide over, is often said by people who knew a completed suicide. You cannot assume that because you feel something is not worth being suicidal about, that the person you are with feels the same way. It is not how bad the problem is, but how badly it’s hurting the person who has it.1.Remember: suicidal behavior is a cry for help.

2.Myth: If a someone is going to kill himself, nothing can stop him. The fact that a person is still alive is sufficient proof that part of him wants to remain alive. The suicidal person is ambivalent — part of him wants to live and part of him wants not so much death as he wants the pain to end. It is the part that wants to live that tells another I feel suicidal. If a suicidal person turns to you it is likely that he believes that you are more caring, more informed about coping with misfortune, and more willing to protect his confidentiality. No matter how negative the manner and content of his talk, he is doing a positive thing and has a positive view of you.

3.Be willing to give and get help sooner rather than later.

4.Suicide prevention is not a last minute activity. All textbooks on depression say it should be reached as soon as possible. Unfortunately, suicidal people are afraid that trying to get help may bring them more pain: being told they are stupid, foolish, sinful, or manipulative; rejection; punishment; suspension from school or job; written records of their condition; or involuntary commitment. You need to do everything you can to reduce pain, rather than increase or prolong it. Constructively involving yourself on the side of life as early as possible will reduce the risk of suicide.

5.Listen.

6.Give the person every opportunity to unburden his troubles and ventilate his feelings. You don’t need to say much and there are no magic words. If you are concerned, your voice and manner will show it. Give him relief from being alone with his pain; let him know you are glad he turned to you. Patience, sympathy, acceptance. Avoid arguments and advice giving.

7.ASK: Are you having thoughts of suicide?

8.Myth: Talking about it may give someone the idea. People already have the idea; suicide is constantly in the news media. If you ask a despairing person this question you are doing a good thing for them: you are showing him that you care about him, that you take him seriously, and that you are willing to let him share his pain with you. You are giving him further opportunity to discharge pent up and painful feelings. If the person is having thoughts of suicide, find out how far along his ideation has progressed.

9.If the person is acutely suicidal, do not leave him alone.

10.If the means are present, try to get rid of them. Detoxify the home.

11.Urge professional help.

12.Persistence and patience may be needed to seek, engage and continue with as many options as possible. In any referral situation, let the person know you care and want to maintain contact.

13.No secrets.

14.It is the part of the person that is afraid of more pain that says Don’t tell anyone. It is the part that wants to stay alive that tells you about it. Respond to that part of the person and persistently seek out a mature and compassionate person with whom you can review the situation. (You can get outside help and still protect the person from pain causing breaches of privacy.) Do not try to go it alone. Get help for the person and for yourself. Distributing the anxieties and responsibilities of suicide prevention makes it easier and much more effective.

15.From crisis to recovery.
16.Most people have suicidal thoughts or feelings at some point in their lives; yet less than 2% of all deaths are suicides.

Nearly all suicidal people suffer from conditions that will pass with time or with the assistance of a recovery program. There are hundreds of modest steps we can take to improve our response to the suicidal and to make it easier for them to seek help. Taking these modest steps can save many lives and reduce a great deal of human suffering.

WARNING SIGNS
Conditions associated with increased risk of suicide• Death or terminal illness of relative or friend.
•Divorce, separation, broken relationship, stress on family.
•Loss of health (real or imaginary).
•Loss of job, home, money, status, self-esteem, personal security.
•Alcohol or drug abuse.
•Depression. In the young depression may be masked by hyperactivity or acting out behavior. In the elderly it may be incorrectly attributed to the natural effects of aging. Depression that seems to quickly disappear for no apparent reason is cause for concern. The early stages of recovery from depression can be a high risk period. Recent studies have associated anxiety disorders with increased risk for attempted suicide.
Emotional and behavioral changes associated with suicide• Overwhelming Pain: pain that threatens to exceed the person’s pain coping capacities. Suicidal feelings are often the result of longstanding problems that have been exacerbated by recent precipitating events. The precipitating factors may be new pain or the loss of pain coping resources.
•Hopelessness: the feeling that the pain will continue or get worse; things will never get better.
•Powerlessness: the feeling that one’s resources for reducing pain are exhausted.
•Feelings of worthlessness, shame, guilt, self-hatred, no one cares. Fears of losing control, harming self or others.
•Personality becomes sad, withdrawn, tired, apathetic, anxious, irritable, or prone to angry outbursts.
•Declining performance in school, work, or other activities. (Occasionally the reverse: someone who volunteers for extra duties because they need to fill up their time.)
•Social isolation; or association with a group that has different moral standards than those of the family.
•Declining interest in sex, friends, or activities previously enjoyed.
•Neglect of personal welfare, deteriorating physical appearance.
•Alterations in either direction in sleeping or eating habits.
•(Particularly in the elderly) Self-starvation, dietary mismanagement, disobeying medical instructions.
•Difficult times: holidays, anniversaries, and the first week after discharge from a hospital; just before and after diagnosis of a major illness; just before and during disciplinary proceedings. Undocumented status adds to the stress of a crisis.
Suicidal Behavior•Previous suicide attempts, mini-attempts.
•Explicit statements of suicidal ideation or feelings.
•Development of suicidal plan, acquiring the means, rehearsal behavior, setting a time for the attempt.
•Self-inflicted injuries, such as cuts, burns, or head banging.
•Reckless behavior. (Besides suicide, other leading causes of death among young people in New York City are homicide, accidents, drug overdose, and AIDS.) Unexplained accidents among children and the elderly.
•Making out a will or giving away favorite possessions.
•Inappropriately saying goodbye.
•Verbal behavior that is ambiguous or indirect: I’m going away on a real long trip., You won’t have to worry about me anymore., I want to go to sleep and never wake up., I’m so depressed, I just can’t go on., Does God punish suicides?, Voices are telling me to do bad things., requests for euthanasia information, inappropriate joking, stories or essays on morbid themes.

A WARNING ABOUT WARNING SIGNS
The majority of the population at any one time does not have many of the warning signs and has a lower suicide risk rate. But a lower rate in a larger population is still a lot of people – and many completed suicides had only a few of the conditions listed above. In a one person to another person situation, all indications of suicidality need to be taken seriously.
Crisis intervention hotlines that accept calls from the suicidal, or anyone who wishes to discuss a problem, are (in New York City) The Samaritans at 212-673-3000 and Helpline at 212-532-2400.

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HOW SLEEP HELPS:

Sleep may seem like a waste of time. You could instead be answering e-mail, doing the dishes, repairing the deck or decking the halls. But research shows that you’re more likely to succeed at your tasks—and enjoy greater well-being—if you get some serious shuteye.
Of course, it’s not easy to sleep when you’re feeling overwhelmed. In fact, nearly two-thirds of Americans say they lose sleep because of stress. That’s especially unfortunate because sleepcombats some of the fallout of stress, and poor sleep has been linked to significant problems, including:
•greater risk of depression and anxiety
•increased risk of heart disease and cancer
•impaired memory
•reduced immune system functioning
•weight gain
•greater likelihood of accidents
Creating Good Nights

Are You Getting Enough Rest?

Experts suggest that adults get seven to nine hours of sleep a night. Everyone is different, though, and you may need more after a few days of burning the midnight (or 2 a.m.) oil.
To assess your sleep deficit, ask yourself:
•Am I often tired?
•Am I using caffeine to get through the day?
•Do I sleep well?
•Do I wake up feeling refreshed?
•Do I get drowsy while driving or watching TV?
Tips for Upping Your Sleep

To sleep longer—and better—consider these suggestions:
•Set a regular bedtime. Your body craves consistency, plus you’re more likely to get enough sleep if you schedule rest like your other important tasks.
•De-caffeinate yourself. Drinking caffeine to stay awake during the day can keep you up at night. Try resisting the coffee and colas starting six to eight hours before bed.
•De-stress yourself. Relax by taking a hot bath, meditating or envisioning a soothing scene while lying in bed. Turn off daytime worries by finishing any next-day preparations about an hour before bed.
•Exercise. Working out can improve sleep in lots of ways, including by relieving muscle tension. Don’t work out right before bed, though, since exercise may make you more alert. If you like, try gentle upper-body stretches to help transition into sleep.
•Make your bed a sleep haven. No paying bills or writing reports in bed. Also, if you can’t fall asleep after 15 minutes you can try some soothing music, but if you remain alert experts recommend getting up until you feel more tired.
For additional sleep guidelines, see the National Sleep Foundation’s website. (But no computer right before bedtime!)

More Sleep Aids

If you’re considering sleep medication, you can buy one of several over-the-counter products, which generally can be used safely for a few days. As for prescription medications, the National Sleep Foundation suggests a limit of four weeks—and simultaneously working on one’s sleep habits. Never combine sleep medications with alcohol or other potentially sedating medicines, and be sure to allow at least 8 hours between taking a sleep medication and driving.

If you’re wondering about the hormone melatonin, there is evidence of its usefulness in improving sleep and helping to regulate an off-kilter sleep cycle. Still, some experts urge caution, arguing that more research is needed to determine correct dosing and timing for taking a melatonin supplement.

If you’re having serious sleep problems, see your doctor, especially if you have trouble more than three nights a week for a month. Your doctor can check whether your sleep issues are caused by some underlying health problem, like depression or a thyroid disorder, and can help with a treatment plan or referral to a sleep specialist. Also contact your doctor if you suspect a sleep disorder, like sleep apnea, which involves snoring and gaps in breathing, or restless leg syndrome, which causes sudden urges to move your body, or if you are experiencing any unusual nighttime behaviors. It’s also reasonable to see a health care professional if you still feel tired despite getting enough sleep.

If you want help learning to cope better with sleep problems, try to locate a therapist who offers cognitive-behavioral therapy for insomnia. This treatment works by changing sleep-related beliefs and behaviors. You might, for example, rethink your notion that the whole night is ruined if you’re not asleep by 10. A sleep clinic may be able to help you locate such a therapist.

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I just heard on the news that the FDA is recalling a generic version of Wellbutrin XL (bupropion XL). Can you explain this? Should I stop taking my medication?
By: Karen E. Moeller, PharmD, BCPP

The Food and Drug Administration (FDA) announced in early October that the generic medication Budeprion XL 300 mg, which has the same active ingredient, bupropion hydrochloride, as Wellbutrin XL, manufactured by Impax Laboratories, Inc. and marketed by Teva Pharmeuticals USA, Inc. was not equivalent to the brand name drug Wellbutrin XL 300 mg. The FDA has asked Impax/Teva to recall or remove Budeprion XL 300 mg from the market. Wellbutrin XL is approved for treatment of major depressive disorder and seasonal affective disorder. Results from a recent study of people taking Budeprion XL 300 mg conducted by the FDA found that only 75 percent of the medication entered the bloodstream. Thus people who were switched from brand name Wellbutrin XL to Budeprion XL may see return of symptoms of depression or lack of effectiveness from the drug. However, this was NOT found with the 150 mg strength of Budeprion XL and the FDA has stated that the 150 mg strength of Budeprion XL is bioequivalent to Wellbutrin XL 150 mg.

It is also important to note that there are currently four other generic manufacturers that produce generic versions of Wellbutrin XL 300 mg. These generic products have NOT been recalled by the FDA. Additionally, the FDA believes the results from their study only apply to the Impax/Teva generic product based on consumer complaints. However, the FDA has asked the other generic manufacturers to study the bioequivalence of their 300 mg product to Wellbutrin XL 300 mg.

Consumers may wonder why the FDA approved this generic formulation if it was not bioequivalent. The FDA does require generic manufacturers to demonstrate that their medication is bioequivalent to the brand name product. In the case of Wellbutrin XL generic manufacturers compared their 150 mg product to the brand name Wellbutrin XL 150 mg. Results from these studies found the 150 mg strengths comparable. However, studies were not conducted on the 300 mg strengths of their product. Results from the bioequivalence studies of the 150 mg strength were used to approve the 300 mg product. Thus no direct comparisons were made between the 300 mg strengths.

One may also be worried about taking generic medications after reading this report. Overall there are over 10,000 FDA approved generic medications and complaints about generic drugs are rare. It is important when a prescription is picked up to check and see if there has been a switch to a generic medication or if there has been a switch to a different generic made from another generic manufacturer. If new side effects or worsening symptoms occur while taking these new products, contact a health care professional and ask them to report it to the FDA.
Take home points

This recall only effects the generic Impax/Teva Budeprion XL 300 mg strength
Impax/Teva Budeprion XL 150 mg has been shown to be bioequivalent to Wellbutrin XL 150 mg and is not part of the recall
The generic Impax/Teva Budeprion XL 300 mg is a yellow, oval, film-coated tablet with “682” on one side and blank on the other side
If you are unsure of the generic Wellbutrin XL you are taking, ask your pharmacist.
Do not stop taking your medication! If you have the Impax/Teva brand talk with your pharmacist or healthcare provider.
Always be aware of what your medications looks like. If it appears different talk with your pharmacist.
For more information on the recall go to the FDA website.
References

U.S. Food and Drug Administration (2012, Oct 3). Questions and Answers Regarding Market Withdrawal of Budeprion XL 300 mg Manufactured by Impax and Marketed by Teva. Retrieved from http://www.fda.gov/D…cm322160.htm#q2

U.S. Food and Drug Administration (2012, Oct 3). FDA Update: Budeprion XL 300 mg Not Therapeutically Equivalent to Wellbutrin XL 300 mg. Retrieved from http://www.fda.gov/D…s/ucm322161.htm

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When depression drugs don’t help, talking might

Rachael Rettner
MyHealthNewsDaily
Talk therapy may be a helpful supplemental treatment for people with depression who have not responded to medication, a new study from the United Kingdom suggests.
Researchers found that people with depression who had not improved despite taking antidepressants were three times more likely to experience a reduction in their depression symptoms if talk therapy was added to their treatment regimen compared with those who continued to take only antidepressants.
The study is one of the first large trials to test the effectiveness of talk therapy given in tandem with antidepressants, the researchers said.
Up to two-thirds of people with depression don’t respond fully to antidepressant treatment, and the findings suggest a way to help this group, the researchers said.
“Until now, there was little evidence to help clinicians choose the best next step treatment for those patients whose symptoms do not respond to standard drug treatments,” study researcher Nicola Wiles of the University of Bristol’s Centre for Mental Health, Addiction and Suicide Research said in a statement.
The study followed patients for one year. Future studies should examine the effectiveness of this treatment combination over the long term, as patients with depression can relapse after treatment, the researchers said.
In addition, because some patients did not improve substantially when talk therapy was added, further research is needed to find alternative treatments for this group, Wiles added.
The study included about 470 people with depression who had not responded to antidepressants after six weeks of treatment. About half received cognitive behavioral therapy — a type of talk therapy — in addition to their usual antidepressant treatment, and half continued antidepressants without the addition of talk therapy.

After six months, about 46 percent of patients in the talk therapy group experienced at least a 50 percent reduction in their depressive symptoms. By contrast, 22 percent of people in the antidepressant group improved by the same amount. By the 12-month mark, both groups experienced similar rates of improvement.
Often, talk therapy is more difficult to access than medication, the researchers said. And people may not be able to afford the treatment if their health insurance does not cover it. Only about 25 percent of Americans with depression have received talk therapy during the past year, they said.