Moderator Emeritus dalsaan Posted January 6, 2015 Moderator Emeritus Share Posted January 6, 2015 Gains in employment status following antidepressant medication or cognitive therapy for depression +Author Affiliations Jay C. Fournier, PhD, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Robert J. DeRubeis, PhD, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania; Jay Amsterdam, MD, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Richard C. Shelton, MD, Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, Alabama; Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA Background Depression can adversely affect employment status. Aims To examine whether there is a relative advantage of cognitive therapy or antidepressant medication in improving employment status following treatment, using data from a previously reported trial. Method Random assignment to cognitive therapy (n = 48) or the selective serotonin reuptake inhibitor paroxetine (n = 93) for 4 months; treatment responders were followed for up to 24 months. Differential effects of treatment on employment status were examined. Results At the end of 28 months, cognitive therapy led to higher rates of full-time employment (88.9%) than did antidepressant medication among treatment responders (70.8%), χ21 = 5.78, P = 0.02, odds ratio (OR) = 5.66, 95% CI 1.16-27.69. In the shorter-term, the main effect of treatment on employment status was not significant following acute treatment (χ21 = 1.74, P = 0.19, OR = 1.77, 95% CI 0.75-4.17); however, we observed a site×treatment interaction (χ21 = 6.87, P = 0.009) whereby cognitive therapy led to a higher rate of full-time employment at one site but not at the other. Conclusions Cognitive therapy may produce greater improvements in employment v.medication, particularly over the longer term. http://bjp.rcpsych.org/content/early/2014/05/23/bjp.bp.113.133694.abstract Please note - I am not a medical practitioner and I do not give medical advice. I offer an opinion based on my own experiences, reading and discussion with others.On Effexor for 2 months at the start of 2005. Had extreme insomnia as an adverse reaction. Changed to mirtazapine. Have been trying to get off since mid 2008 with numerous failures including CTs and slow (but not slow enough tapers)Have slow tapered at 10 per cent or less for years. I have liquid mirtazapine made at a compounding chemist. Was on 1.6 ml as at 19 March 2014. Dropped to 1.5 ml 7 June 2014. Dropped to 1.4 in about September. Dropped to 1.3 on 20 December 2014. Dropped to 1.2 in mid Jan 2015. Dropped to 1 ml in late Feb 2015. I think my old medication had run out of puff so I tried 1ml when I got the new stuff and it seems to be going ok. Sleep has been good over the last week (as of 13/3/15). Dropped to 1/2 ml 14/11/15 Fatigue still there as are memory and cognition problems. Sleep is patchy but liveable compared to what it has been in the past. DRUG FREE - as at 1st May 2017 >My intro post is here - http://survivingantidepressants.org/index.php?/topic/2250-dalsaan Link to comment Share on other sites More sharing options...
Administrator Altostrata Posted January 6, 2015 Administrator Share Posted January 6, 2015 Interesting. Link, please! This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner. "It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein All postings © copyrighted. Link to comment Share on other sites More sharing options...
Moderator Emeritus dalsaan Posted January 6, 2015 Author Moderator Emeritus Share Posted January 6, 2015 have provided a link to the abstract Please note - I am not a medical practitioner and I do not give medical advice. I offer an opinion based on my own experiences, reading and discussion with others.On Effexor for 2 months at the start of 2005. Had extreme insomnia as an adverse reaction. Changed to mirtazapine. Have been trying to get off since mid 2008 with numerous failures including CTs and slow (but not slow enough tapers)Have slow tapered at 10 per cent or less for years. I have liquid mirtazapine made at a compounding chemist. Was on 1.6 ml as at 19 March 2014. Dropped to 1.5 ml 7 June 2014. Dropped to 1.4 in about September. Dropped to 1.3 on 20 December 2014. Dropped to 1.2 in mid Jan 2015. Dropped to 1 ml in late Feb 2015. I think my old medication had run out of puff so I tried 1ml when I got the new stuff and it seems to be going ok. Sleep has been good over the last week (as of 13/3/15). Dropped to 1/2 ml 14/11/15 Fatigue still there as are memory and cognition problems. Sleep is patchy but liveable compared to what it has been in the past. DRUG FREE - as at 1st May 2017 >My intro post is here - http://survivingantidepressants.org/index.php?/topic/2250-dalsaan Link to comment Share on other sites More sharing options...
dcrmt Posted January 20, 2015 Share Posted January 20, 2015 It's a damn shame that there wasn't a 'no treatment' group. Also it's not clear to me whether they measured the change in employment status at all or if they just looked at where people were 24 months after treatment.I'd strongly suspect that treatment with SSRI's, especially paroxetine would have a negative effect on employment. Link to comment Share on other sites More sharing options...
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