Objective: To access the efficacy of cognitive behavioral therapy (CBT) in addition to pharmacotherapy versus pharmacotherapy alone in the treatment of major depressive disorder

Methodology: A case-control study was conducted at different psychiatric clinics in Pakistan between April 2019 to October 2020. All participants with depression were divided into two groups; Group A patients were treated in compliance with the current treatment guidelines for antidepressant pharmacotherapy whereas patients in Group B were managed with CBT which included 15 individual 45 minutes sessions in addition to pharmacotherapy. The efficiency of the treatment was assessed on PHQ-9, with treatment being considered successful in patients with a significantly improved score.

Results: 53.80% participants of Group A and 37.50% participants of Group B with moderate depression suffered a depressive episode within the last 12 months whereas 46.20% participants of Group A and 62.50% participants of Group B with moderate depression suffered a depressive episode the last 12 months. However, 49.50% participants of Group A and 83.30% participants of Group B with moderately severe depression suffered a depressive episode within the last 12 months whereas 50.50% participants of Group A and 16.70% participants of Group B with Moderately severe depression suffered a depressive episode the last 12 months.  Escitalopram was the most common prescribed antidepressant (44.8%).

Conclusion: It was found that CBT in addition to Pharmacotherapy was more effective in moderate depression whereas Pharmacotherapy alone was much more effective in Moderately Severe depression.

Keywords: cognitive behavioral therapy, major depressive disorder, pharmacotherapy, CBT, PHQ-9