Cognitive-behavioral therapy limitations

Kranzler HR, Del Boca F, Korner P, et ah Adverse effects limit the usefulness of flu-voxamine for the treatment of alcoholism.] Subst Abuse Treat 10 283-287, 1993 Kranzler HR, Burleson JA, Del Boca FK, et ah Buspirone treatment of anxious alcoholics a placebo-controlled trial. Arch Gen Psychiatry 31 720—731, 1994 Kranzler HR, Burleson JA, Korner P, et ah Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics. Am] Psychiatry 152 391-397, 1995 Kranzler HR, Burleson JA, Brown J, et al Fluoxetine treatment seems to reduce the beneficial effects of cognitive-behavioral therapy in type B alcoholics. Alcohol Clin Exp Res 20 1534-1341, 1996... 

In the Treatment of SSRl-Resistant Depression in Adolescents (TORDIA) study [7 ], 334 depressed adolescents, who had not responded to a previous trial with an SSRl antidepressant, were randomized to either another SSRl or venlafaxine, with or without cognitive behavioral therapy. There were no significant differences between the groups in the rates of suicidal and non-sui-cidal self-injury, although the significance of this was limited by the lack of a placebo comparison group [8 J. 

In addition to antidepressant drugs, some forms of psychological treatments have been shown effec tive for treatment of major depressive disorder. These include cognitive behavioral psychotherapy and interpersonal psychotherapy (Weissman, 1979). These therapies differ from traditional psychoanalytically oriented methods in that the therapist takes an active role, the patient is expected to do homework, and the treatment is time limited, usually for about six months. Little data are available regarding whether the combination of medications and psychotherapy is more effective than either treatment alone, but data are suggestive of an additive effect. 

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