Combined Psychotherapy and Pharmacotherapy

Overall, support for pharmacological treatment of depression in individuals with SCI is largely an extrapolation from the extant literature concerning use in the general population and comparative trials of medications and cognitive behavioural interventions are “sorely needed” (Elliott & Kennedy 2004).

Discussion

Two PCTs reported significant improvement in depressive symptoms in the combined CBT and antidepressant group compared to usual care (Kahan et al., 2006; Kemp et al. 2004). Two prepost studies reported combined supportive psychotherapy and pharmacotherapy resulted in improvement of depressive symptoms amongst persons with SCI (Judd et al, 1986; Judd et al. 1989).

Conclusion

There is level 2 evidence (Kahan et al., 2006; Kemp et al., 2004) that combined CBT and antidepressants reduce symptoms of depression post SCI.

There is level 4 evidence (Judd et al. 1986; Judd et al. 1989) indicating the effectiveness of pharmacotherapy combined with supportive psychotherapy for reducing symptoms of depression in SCI.