Treating Major Depressive Disorder After Suboptimal Response to Antidepressant Treatment: Where Do Digital Mental Health Tools Fit in?

Abstract: Introduction: Less than half of patients receiving first-line antidepressant (ADT) treatment for major depressive disorder (MDD) achieve remission. When considering the next treatment strategy, healthcare professionals (HCPs) must assess benefits, risks, and other factors. Digital mental health tools (DMHTs) are a newer option for consideration. Methods: US HCPs were surveyed online and in person in 2023–2024 about their treatment choices for patients with MDD who show a suboptimal response to ADT. The use of DMHTs was also assessed. All results were descriptive and not tested for statistical significance. Results: There were 79 respondents, most of whom were NPs (39.2%) or MDs (34.2%) specializing in psychiatry (62.0%). For patients with suboptimal response to ADTs, the most frequent choice for next strategy was to augment with another medication class (38/79; 48.1%); most (32/38; 84.2%) reported atypical antipsychotics as their first choice of augmentation. Only 2 HCPs noted that they would switch to a DMHT. Of the 65 HCPs who responded about prior DMHT use, 20 had previously used DMHTs at the time of the survey. The most commonly used DMHTs were wellness apps (14/20). The need for more RCTs with clinical outcomes was selected by 52.7% (39/74) of HCPs when considering DMHT use. Conclusions: This survey suggests that pharmacological augmentation strategies are the HCPs’ first choice when patients have a suboptimal response to ADT. The use of DMHTs in the treatment of MDD is infrequent. HCPs desire more RCTs before considering DMHTs.Short Description: US healthcare professionals (HCPs; Nf79) were surveyed about next treatment choice (including digital mental health tools [DMHTs]) for patients with MDD experiencing a suboptimal response to antidepressant treatment. The most frequent next treatment strategy was augmentation with another medication class (38/79). Of the 20 HCPs who reported prior DMHT use, the most used DMHTs were wellness apps (14/20). Of those HCPs who responded (n=74), 52.7% wanted to see more RCTs before considering DMHTs.Name of Sponsoring Organization(s): This study was funded by Otsuka Pharmaceutical Development & Commercialization, Inc.