MDD Treatment Landscape


Expert panelists discuss the lack of diversity among available treatment options for MDD.

H. Eric Cannon, PharmD, FAMCP: When we look at the diversity of available treatment options and dozens of therapeutic options, most of them within several classes, it puts the clinician in a situation where many times the first 2 or 3 options are guesses. National guidelines have stated to start with an SSRI [selective serotonin reuptake inhibitor], try another if that fails, and then try another if that fails. It’s important to work with our clinicians so that they understand the benefits of each therapeutic option and try to align that with patients. They try to say, “You’re activated. Let’s try something that has more of a depressive effect that can bring you down and also help with depression,” but it’s difficult. We’re making progress. We’ve got genetic tests and a few things to help us identify opportunities for improvement, but it’s critical to have new treatments that work fast.

Michael Rothrock, MBA, MHA: The perception of the diversity of the treatment options is extremely limited. The mechanisms of action [MOAs] are fairly consistent, whether they’re SSRIs, SSNRIs [selective serotonin-norepinephrine reuptake inhibitor], or even things like old legacy TCAs [tricyclic antidepressants]. As Eric mentioned, most physicians are going to try an SSRI and titrate it up to a tolerability or, if doesn’t work, do it again with a different molecule. There aren’t a lot of efficacious options if they’ve already failed the comparable MOA they’ve previously been on. There might be some nuances in tolerability, but I don’t think the efficacy benefits are that differentiated.

Transcript edited for clarity.

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