Quantified superiority of cognitive behaviour therapy to antidepressant drugs: a challenge to an earlier meta‐analysis

Objective:  The study aimed to review the conclusion of a previously published meta‐analysis which quantified distinct superiority of cognitive therapy to antidepressant drug‐therapy ( P  < 0.0001). Method:  We sought to include all studies used in the original meta‐analysis. Adopting both that study’s inclusion criteria and additional criteria resulted in a reduced set of studies. We analysed both ‘completer’ and ‘intention to treat’ data, using effect size and odds ratio quantification. Results:  There was an overall trend for cognitive therapy to be superior to antidepressant drug‐therapy, but this was significant for only one of the four meta‐analyses (an intention to treat analysis). We demonstrated considerable heterogeneity between studies, and a significantly higher drop‐out rate in the antidepressant groups. Conclusion:  The previous interpretation – cognitive therapy being distinctly superior to antidepressant medication – cannot be sustained from the currently analysed data set.