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To the Editor: While the TADS trial provides valuable data about a significant problem, we differ from the authors in their conclusion that treatment with fluoxetine should be made widely available, and that CBT in combination with fluoxetine should be "readily available as part of comprehensive treatment for depressed adolescents."¹ Because 2 of 3 outcome measures (Clinical Global Impressions [CGI] and Reynolds Adolescent Depression Scale [RADS]) show no significant difference between fluoxetine treatment alone and fluoxetine in combination with CBT, we do not see this study showing an advantage for the addition of CBT in all adolescents with MDD.

The Suicidal Ideation Questionnaire-Junior High School Version showed significantly more improvement with fluoxetine in combination with CBT compared with fluoxetine alone. Although this difference may not apply to attempted or completed suicides, it does lend support for the use of fluoxetine in combination with CBT for adolescents with MDD and suicidal . . . [Full Text of this Article]

Arthur Rifkin, MD
Department of Psychiatry
Zucker-Hillside Hospital
North Shore-Long Island Jewish Health System
New Hyde Park, NY

William Rifkin, MD
william.rifkin@yale.edu
Department of Medicine
Yale University School of Medicine
New Haven, Conn

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