While an estimated 74-percent of patients diagnosed with major depression receive a prescription for an antidepressant, new research reveals that mindfulness-based cognitive therapy (MBCT) may be most helpful when drugs are not used. The study, published in the current issue of Psychotherapy and Psychosomatics, found that the participants in a randomized control trial for MBCT who showed the greatest improvement were those who had not taken antidepressants.
The researchers explain that antidepressants are known to reduce the neural processing of both rewarding and aversive stimuli, causing “emotional blunting,” and that this may prevent the generation of positive emotions that are essential for therapy.
“Since the generation of positive emotions is crucial in the initiation of a positive spiral towards recovery, long-term outcomes of this contingent inhibiting effect of antidepressants on psychotherapy outcome in terms of positive affect will have to be investigated in more detail in experimental set-ups,” the researchers conclude.
“If our findings are replicated it would implicate that the sequential addition of psychotherapy to antidepressants could be less efficient than discontinuing antidepressants before/during receiving psychotherapy especially for improving long-term outcomes.”
Bakker, J.M., Lieverse, R., Geschwind, N., Peeters, F., Myin-Germeys, I. and Wichers, M., 2016. The Two-Sided Face of Antidepressants: The Impact of Their Use on Real-Life Affective Change during Mindfulness-Based Cognitive Therapy. Psychotherapy and Psychosomatics, 85(3), pp.180-182. (Full Text)