Real-World Treatment Experiences and Expectations by Symptom Severity in Patients With Major Depressive Disorder

Abstract: Major Depressive Disorder (MDD) is characterized by depressed mood, anhedonia, and diminished quality of life. The varying severity of MDD symptoms impacts treatment response and patient experiences. A survey, developed with input from mental health experts and patients through the Depression and Bipolar Support Alliance (DBSA), evaluated treatment expectations and experiences among individuals with MDD. Conducted from 12/2021—1/2022, the survey included US adults self-reporting MDD. Depression severity was assessed using the 16-item Quick Inventory of Depressive Symptomatology, examining associations between severity, treatment experiences and expectations. Among 385 respondents, varying levels of depression severity were observed: none/mild (n=56; 14.5%), moderate (n=139; 36.1%), severe/very severe (n=190; 49.4%). Those with severe/very severe depression were typically younger, had higher rates of attention deficit hyperactivity disorder and post-traumatic stress disorder, received 4+ lines of therapy, and had shorter MDD treatment durations. Current treatments included SSRIs (39%), SNRIs (27%), bupropion (22%), and antipsychotics (22%). Respondents experiencing none/mild severity generally reported higher satisfaction, confidence in treatment efficacy, and functional ability, alongside fewer bothersome side effects than those with moderate or severe/very severe disease. Most impactful side effects reported by all respondents were weight gain, cognitive impairment, and sexual dysfunction. Overall, 84% of all respondents wished for immediate or within-one-week treatment responses. Improved functionality, increased interest/pleasure, and reduced feelings of hopelessness/anxiety/agitation were reported as respondents’ main treatment goals. This recent survey revealed distinct characteristics among individuals with varying MDD severity. While those with higher severity reported less favorable treatment experiences, all respondents favored treatments with rapid onset.Short Description: MDD presents treatment challenges, with varying symptom severity impacting treatment efficacy and patient outcomes. A recent survey with 385 respondents examined associations between severity and treatment experiences and expectations. Severe cases, predominantly younger, reported higher dissatisfaction and side effects with common antidepressants like SSRIs. Rapid-onset treatment was universally desired. Recognizing severity nuances is essential for tailored interventions and aligning patient expectations, optimizing long-term MDD management.Name of Sponsoring Organization(s): Axsome Therapeutics