Therapy versus medication: Comparing treatments for depression in heart disease

Jan. 29, 2024
Cedars-Sinai study shows behavioral activation therapy as effective as antidepressant medications for treatment of depression in heart failure patients.

New research by investigators from the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai shows that behavioral activation therapy is as effective as antidepressant medications in treating symptoms of depression in patients with heart failure.

The study, which was published in the peer-reviewed journal JAMA Network Open, followed more than 400 patients over the course of a year. Half of the study participants received antidepressant medication management to treat depression symptoms while the other half participated in behavioral activation psychotherapy, an evidence-based treatment for depression that promotes engagement in activities a patient finds enjoyable. 

The research was done in close collaboration with the Smidt Heart Institute at Cedars-Sinai, and its heart failure program led by Michele Hamilton, MD, vice chair of the Department of Cardiology in the Smidt Heart Institute and co-author of the study.

Investigators say there was no statistically significant difference between the effectiveness of the two methods, with each patient group experiencing a more than 50% reduction in the severity of depressive symptoms.

Study participants randomized to receive behavioral activation therapy worked with a therapist to develop a personalized list of activities that bring them joy and fulfillment, including having lunch with a friend, taking a walk, volunteering, listening to their favorite music—among other options—on a regularly scheduled basis. The treatment focused on increasing the level of enjoyable and rewarding activities the patient was doing every week for 12 weeks, and then incorporating them into their regular activity schedule.

Patients who received psychotherapy intervention showed a slight improvement in their physical and mental health-related quality of life, a secondary outcome monitored by the study. They also had fewer emergency department visits and spent fewer days hospitalized during the course of the study compared with the patients who were randomized to receive antidepressant medications.

Cedars-Sinai release