Depressed individuals who fail to respond to initial treatment with an antidepressant or psychotherapy may do better if they are switched to the alternative treatment, new study findings suggest.

“Surprisingly few studies have evaluated the role of medication following nonresponse to psychotherapy,” the authors of the study say and “none has evaluated the efficacy of psychotherapy following nonresponse to medication.”

Dr. Alan F. Schatzberg, at Stanford University in California, and associates followed 140 patients who failed initial treatment with the antidepressant Serzone (nefazodone) or cognitive behavioral psychotherapy. Thirty patients dropped out of the study.

Patients were crossed over from Serzone to psychotherapy or from psychotherapy to Serzone.

The overall response rate was 57 percent among those crossed over to psychotherapy and 42 percent among those crossed over to Serzone.

Therefore, for chronically depressed patients, the present results provide a strong basis for switching to psychotherapy after a medication fails to alleviate depression and, conversely, for switching to medication when psychotherapy fails to relieve depression.

Arch Gen Psychiatry 2005;62:513-520.