Adding medication to therapy for moderate to severe depression in Zimbabwe

This trial is testing whether adding antidepressants to a brief talking therapy program called the Friendship Bench helps people with moderate to severe depression get better results. The Friendship Bench is a simple, practical therapy delivered by trained community health workers where you learn problem-solving skills. The study is comparing this therapy alone versus this therapy combined with the medication to see which approach works better.

Depression is very common in Zimbabwe, but most people don't get treated because there aren't enough mental health specialists. While international guidelines recommend combining medication with therapy for moderate to severe depression, there's very little evidence about whether this approach actually works in low-income countries like Zimbabwe. This trial will help the government decide whether to offer the medication alongside the Friendship Bench in primary care clinics.