Generally speaking, we're big fans of CBT as an insomnia treatment. It doesn't involve medication, and it can be remarkably effective. That being said, it would appear that when used to treat depression in teenagers, CBT is less effective if the individual also suffers from insomnia. This is a major finding, since insomnia is a common side effect of depression - 75% of depressed teenagers are also insomniacs.
The study found that in depressed teenagers with insomnia, cognitive behavioral therapy alone was only effective in a quarter of cases at six weeks. In depressed teenagers without insomnia, cognitive behavioral therapy was effective in almost half of all cases. It's worth mentioning that it's not all bad news; by week twelve, the response rates were similar. However, the variance in response rates at six weeks is still important as the earlier patients respond to treatment, the likelier they are to have a positive outcome.
This is the first time we've come across a study that suggests insomnia itself may actually interfere with treatment for depression. Armed with this knowledge, hopefully we'll see a two-pronged approach to tackling teenage depression in the future since it now appears that treating depression whilst ignoring insomnia leads to lower treatment response rates.
It's worth adding that simply adding fluoxetine monotherapy (a selective serotonin reuptake inhibitor commonly used to treat depression) to CBT had no effect on teenage insomniacs in this latest study, so ideally we want to see future research investigate what additional treatments may be necessary to improve insomnia as part of the overall treatment for depression.
Last updated: December 5, 2011