*In a meta-analysis of 17 randomized, double-blind, placebo-controlled trials of 14,779 adult patients with MDD, early improvement was defined as a ≥20% or ≥25% reduction in Hamilton Depression Rating Scale (HAMD)/Montgomery-Åsberg Depression Rating Scale (MADRS) sum score of depression severity from baseline to day 7 or 14 of treatment. Remission was defined as a cut-off score ≤7 in the HAMD or ≤12 in the MADRS at the end of treatment.5
§Based on a meta-analysis of 17, randomized, double-blind, placebo-controlled trials of 14,779 adult patients with MDD that assessed the predictive power of early improvement on later response and remission of MDD.5
||According to a 2010 review assessing the impact of the timing of antidepressant effects on various therapies used to treat MDD.6
~3 in 4 patients initiating an antidepressant had a treatment change by the end of a 1-year follow-up period.9¶
According to an analysis of 2,280 adults with MDD treated with an antidepressant, the proportion of patients with severely impaired quality of life increased from10#:
~50% after 1 line of therapy~70% after 4 lines of therapy
~50%after 1 line of therapy
~70% after 4 lines of therapy
¶Based on a retrospective, observational analysis of IBM MarketScan US commercial claims data from January 1, 2017– December 31, 2018. Treatment patterns (persistence, discontinuation, switch, combination, and augmentation) were analyzed for patients with MDD starting first-line antidepressant monotherapy for up to 12 months following their antidepressant initiation index date.9
#Based on an analysis of 2,280 adult MDD out-patients treated with an antidepressant therapy that examined quality of life at the entry and exit of each of the four levels of the acute treatment phase, as well as the 12-month follow-up phase, of the STAR*D study. Quality of life (QOL) was measured using the QOL Enjoyment and Satisfaction Questionnaire (Q-LES-Q).10
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References: 1. Hu XH, Bull SA, Hunkeler EM. Incidence and duration of side effects and those rated as bothersome with selective serotonin reuptake inhibitor treatment for depression: patient report versus physician estimate. J Clin Psychiatry. 2004;65(7):959-965. 2. Hung C-I, Wang S-J, Liu C-Y. Comorbidities and factors related to discontinuation of pharmacotherapy among outpatients with major depressive disorder. Compr Psychiatry. 2011;52(4):370-377. 3. Papakostas GI, Fava M. Does the probability of receiving placebo influence clinical trial outcome? A meta-regression of double-blind, randomized clinical trials in MDD. Eur Neuropsychopharmacol. 2009;19:34-40. 4. Rush AJ, Travedi MH, Wisniewski SR. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11)1905-1917. 5. Wagner S, Engel A, Engelmann J, et al. Early improvement as a resilience signal predicting later remission to antidepressant treatment in patients with major depressive disorder: systematic review and meta-analysis. J Psychiatric Res. 2017;94:96-106. 6. Machado-Vieira R, Baumann J, Wheeler-Castillo C, et al. The Timing of Antidepressant Effects: A Comparison of Diverse Pharmacological and Somatic Treatments. Pharmaceuticals (Basel). 2010;3(1):19-41. 7. Sicras-Mainar, Maurino J, Cordero L, et al. Assessment of pharmacological strategies for management of major depressive disorder and their costs after an inadequate response to first-line antidepressant treatment in primary care. Ann Gen Psychiatry. 2012;11:22-3. 8. Papakostas GI. Managing partial response or nonresponse: switching, augmentation, and combination strategies for major depressive disorder. J Clin Psychiatry. 2009:70(suppl 6):16-25. 9. Zhu L, Ferries E, Suthoff E, et al. Economic burden and antidepressant treatment patterns among patients with major depressive disorder in the United States. JCMP. 2022;28(11):S1-S13. 10. IsHak WW, Mirocha J, James D, et al. Quality of life in major depressive disorder before/after multiple steps of treatment and one-year follow-up. Acta Psychiatr Scand. 2015;131(1):51-60. 11. Demyttenaere K-O, Enzlin P, Dewé W. Compliance with antidepressants in a primary care setting, 1: beyond lack of efficacy and adverse events. J Clin Psychiatry. 2001;62(suppl 22):30-33.