Cognitive behavioral therapy, a form of psychotherapy, may be a good alternative for people with depression for whom antidepressants are not effective, according to a new study — considered the largest randomized trial looking at the benefits of psychotherapy in such patients.

The study, conducted by researchers in Britain, looked at 469 people ages 18 to 75 whose depression symptoms remained after taking antidepressant medication for six weeks or more. Between November 2008 and October 2011, participants either underwent cognitive behavioral therapy (CBT) or continued taking antidepressants while also receiving any type of standard depression care prescribed. Their standard care may have included counseling, or even CBT.