studies, the overall pattern of ﬁndings has been that all three of these approaches are 
about equally effective, at least in the short term. For example, in the largest study 
conducted to date, CBT, ﬂuoxetine (an antidepressant), and a combination of ﬂuoxetine 
and CBT were all found to be about equally effective and were all more effective than 
placebo (Davidson et al. 2004).
Although these approaches are about equally effective in the short term, CBT tends 
to be a more effective treatment than medications over the long term (Liebowitz et al. 
1999). In other words, once all treatments have stopped, people who have been only 
taking medications are more likely to experience a return of symptoms than people who 
had CBT. 
Also, just because these three approaches are about equally effective on average , that 
doesn’t mean that they are equally likely to be effective for you . Some people seem to do 
better with medications, whereas others seem to do best with CBT or a combination of 
these approaches. The approach we usually recommend is to start with either CBT or 
medication, and then introduce the other treatment after several months, if needed.