Add therapy for adults
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Add-On Therapy for Adults: A Comprehensive Overview
Dialectical Behavior Therapy Skills Training for ADHD
Feasibility and Efficacy of DBT-ST
Dialectical Behavior Therapy Skills Training (DBT-ST) has been explored as an add-on treatment for adults with Attention-Deficit/Hyperactivity Disorder (ADHD). A study conducted in Latin America assessed the feasibility and efficacy of DBT-ST in adults with ADHD who were already on stable medication. The results indicated that DBT-ST had a high completion rate (81.25%) and good attendance (87.25%). However, there were no significant improvements in ADHD symptoms compared to the treatment-as-usual group .
Sublingual Immunotherapy for Asthma
Efficacy of SLIT Add-On Therapy
Sublingual immunotherapy (SLIT) has shown promise as an add-on treatment for adults with mild to moderate asthma. A meta-analysis of 20 trials involving 2,288 patients receiving SLIT and 1,268 patients on traditional therapy found that SLIT significantly improved airway scores, lung function, and reduced drug consumption. Additionally, SLIT was associated with marked improvements in airway inflammatory parameters, such as nasal eosinophil infiltration .
Long-Acting Muscarinic Antagonists vs. Beta2-Agonists for Asthma
Comparative Efficacy and Safety
For adults with asthma not well controlled on inhaled corticosteroids (ICS), long-acting muscarinic antagonists (LAMA) and long-acting beta2-agonists (LABA) are considered as add-on therapies. A review of eight studies found no significant difference in exacerbations requiring oral corticosteroids between LAMA and LABA. However, LAMA showed small benefits in lung function, while LABA slightly improved quality of life. The evidence suggests that while both treatments are effective, LABA has a slight edge in quality of life improvements .
Cognitive-Behavioral Therapy for Depression
Sequential Addition of CBT and Antidepressants
For adults with major depressive disorder (MDD) who do not achieve remission with initial treatment, adding cognitive-behavioral therapy (CBT) or antidepressants can be beneficial. A study found that adding CBT to antidepressant treatment or vice versa significantly improved remission rates. Specifically, patients who did not achieve remission with CBT alone showed higher remission rates when antidepressants were added, and similarly, adding CBT to antidepressant treatment was effective for those who did not achieve remission initially .
Meta-Analysis of Combined Therapy
A meta-analysis of 25 randomized trials involving 2,036 patients with depressive disorders found that combining psychotherapy with pharmacotherapy resulted in a small but significant improvement in treatment outcomes compared to pharmacotherapy alone. The dropout rate was also lower in the combined treatment group, indicating better patient adherence .
Meta-Cognitive Therapy for ADHD
Effectiveness of MCT
Meta-Cognitive Therapy (MCT) has been developed to address executive self-management skills in adults with ADHD. A study involving 30 adults showed significant improvements in core ADHD symptoms and executive functioning skills after participating in an 8- or 12-week MCT program. These findings suggest that MCT is a promising treatment for addressing meta-cognitive deficits in adults with ADHD .
Cognitive-Behavioral Therapy for Anxiety Disorders
Efficacy of CBT
Cognitive-behavioral therapy (CBT) is widely used for treating adult anxiety disorders. A meta-analysis of 27 randomized placebo-controlled trials found that CBT significantly reduced anxiety and depressive symptoms compared to placebo. The strongest effects were observed in obsessive-compulsive disorder and acute stress disorder, while the weakest were in panic disorder. These findings underscore the efficacy of CBT in managing various anxiety disorders .
Lacosamide for Focal Epilepsy
Real-World Study on LCM
Lacosamide (LCM) has been evaluated as the first add-on therapy for adult patients with focal epilepsy in China. A multicenter study involving 107 patients found that LCM significantly reduced seizure frequency and improved emotional performance. The treatment was well-tolerated, with only one patient reporting mild dizziness. These results suggest that LCM is an effective and safe add-on therapy for focal epilepsy .
Venlafaxine vs. Stimulant Therapy for ADD and Depression
Comparative Efficacy
A study comparing venlafaxine and stimulant therapy in patients with comorbid ADD and major depressive disorder (MDD) found that venlafaxine monotherapy was as effective as a combination of stimulant and antidepressant therapy. Both treatments were superior to stimulant monotherapy alone, indicating that venlafaxine is a viable option for treating comorbid ADD and MDD .
Clonazepam for Refractory Epilepsy
Lack of Evidence
Despite its use, there is no evidence from double-blind randomized controlled trials to support or refute the efficacy of clonazepam as an add-on therapy for refractory epilepsy in adults and children. This highlights the need for further research in this area .
Conclusion
Add-on therapies offer significant benefits for various conditions in adults, including ADHD, asthma, depression, anxiety disorders, and epilepsy. While some treatments like DBT-ST for ADHD and clonazepam for epilepsy require further research, others like SLIT for asthma and combined CBT and pharmacotherapy for depression have shown promising results. These findings underscore the importance of personalized treatment plans to optimize patient outcomes.
Sources and full results
Most relevant research papers on this topic
Feasibility trial of the dialectical behavior therapy skills training group as add-on treatment for adults with attention-deficit/hyperactivity disorder.
Dialectical Behavior Therapy Skills Training Group (DBT-ST) is a feasible add-on treatment for adult ADHD in Latin America, but shows no significantly higher improvement in symptoms compared to treatment as usual.
Efficacy of add-on sublingual immunotherapy for adults with asthma: A meta-analysis and systematic review.
Long-term SLIT add-on therapy effectively reduces asthma symptoms, improves lung function, and reduces airway inflammation in adults compared to conventional medicine.
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