Comparative benefits and harms of second generation antidepressants and cognitive behavioral therapies in initial treatment of major depressive disorder: systematic review and meta-analysis | The BMJ

http://www.bmj.com/content/351/bmj.h6019

In clinical decision making, providers should consider not only the efficacy of second generation antidepressants and cognitive behavioral therapy interventions but also patients' preferences about potential adverse events, the costs and availability of each treatment, and expected treatment effects. Currently, the biggest barrier to offering psychotherapy either alone or in combination with drugs may be how well patients can gain access to such mental healthcare clinicians. Given that the benefits of second generation antidepressants and cognitive behavioral therapy do not seem to differ significantly in treating major depressive disorder and that primary care patients may have personal preferences for one first line treatment over the other, both treatments should be made accessible, either alone or in combination, to primary care patients with major depressive disorder.8

_- Steve