This 4-8 month study, with a 2-year follow up period, will compare sertraline (Zoloft®),
venlafaxine (Effexor®), supportive-expressive psychotherapy, and placebo to determine which
is more effective in treating major depression.
MDD is one of the most prevalent psychiatric disorders. Different forms of psychotherapy for
depression have been found effective. This study compares a form of dynamic psychotherapy
called supportive-expressive psychotherapy to medication and to placebo.
Participants are evaluated on 2 occasions, 1 week apart, before they are randomly assigned
to receive either supportive-expressive psychotherapy, sertraline (Zoloft) (followed by
venlafaxine [Effexor] if patients do not respond to sertraline), or placebo. The active
phase of treatment lasts 4 months. The frequency of patients' visits depends on the assigned
Patients who are randomized to receive medication or placebo are initially seen on a weekly
basis, then less often, depending on the rate of symptomatic improvement. Patients who are
randomized to psychotherapy are seen twice a week for the first 4 weeks, then once a week
for the remaining 12 weeks. Outcome is monitored at week 2,4,6,7,8, 12, 15 and 16. At the
end of the first 16 weeks of treatment, patients are thoroughly evaluated. Those who have
responded to treatment are assigned to a continuation phase and are seen once a month for
another 16 weeks. At the end of the 16-week continuation phase, patients are again
evaluated and all treatments are stopped. Follow-up continues every 3 months for up to 2
years to ensure that the patients' depression remains under control.
- Major Depressive Disorder diagnosis
- Psychotic or bipolar disorder diagnosis
- Substance dependence in the last 6 months