LEILA FADEL, HOST:
The Food and Drug Administration has approved the first digital tool to help treat major depression. It's an app called Rejoyn, and it's only available through a prescription. At least 21 million American adults have experienced depression, according to the National Institute of Mental Health. So can this app make a difference? We turn now to Dr. John Torous, director of digital psychiatry at Beth Israel Deaconess Medical Center in Boston. Good morning. Thanks for being on the program.
JOHN TOROUS: Thank you so much for having me.
FADEL: So let's start with how significant this is that the FDA has approved a non-drug treatment for major depressive disorder.
TOROUS: I think certainly as a physician and researcher, we always want more treatments to be able to help people with depression. As you said, it's so common.
FADEL: Yeah.
TOROUS: And having a different tool, a different mechanism that we can offer people is, I think, very significant and very important.
FADEL: So what does the app actually do? I mean, I don't think I've ever heard of an app by prescription before.
TOROUS: So there have actually been a couple apps that the FDA has cleared, and some of those actually have gone away. We can talk about that more, but this app actually offers a little bit of cognitive behavioral therapy. It offers some personalized reminders and messaging and something called the emotional faces memory task. That's a little bit newer. But it basically asks you to do different things in the app for six weeks, assuming you're on a medication already in treatment with that provider. So it's not a standalone use-it-yourself app. It's something that you use in addition to treatment you have now.
FADEL: Right. So not a replacement for medication and therapy...
TOROUS: Exactly.
FADEL: ...But something in conjunction with. OK. What did researchers find during the study of this app as a treatment option?
TOROUS: So from reading the FDA documentation of indications for use, what researchers found was they compared this new app to a sham app, basically a placebo. Imagine a digital placebo, just like we have sham digital - sorry, we have sham pills. But...
FADEL: Right.
TOROUS: ...What they ended up finding was that patients got better who used the app, but in one of the key analysis, people who use the sham or control app actually got better about just as much.
FADEL: Oh.
TOROUS: So there wasn't a large difference from placebo.
FADEL: So, well, then what does that say about this app?
TOROUS: So I think it means that certainly the app can be effective for people who use it, but I think it means that we have a lot more to learn about how apps work and how digital health works. But definitely there's a benefit. It's just the question is how much benefit is there and for what people versus a sham or control arm.
FADEL: So you mentioned benefits. Are there any risks?
TOROUS: So according to the FDA documentation, the indications for use, there were minimal risks to using this. None of them, in my personal interpretation, seem related to using the smartphone app, so - and again, this is being used by people who are in treatment already and on a medication. So I think the risks are minimal.
FADEL: I have to ask, though, I mean, with people who are in treatment for severe depression, suffer from isolation, we're so isolated in 2024 because of...
TOROUS: Yeah.
FADEL: ...Screen time. Does this add to patients' burdens in any way?
TOROUS: I think certainly screen time is a hot topic. There's a lot that we're learning about it. I think for some people - for most people, I think screen time may actually not impact your mental health, but I think for most people, in this case, the use of screen time would not make their depression worse from using this app.
FADEL: That's Dr. John Torous, director of digital psychiatry at Beth Israel Deaconess Medical Center in Boston, Mass. Thank you for your time.
TOROUS: Thank you.
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