Characteristics and Treatment Patterns in Patients with Unresolved Major Depressive Disorder

Abstract: Objective: To describe key characteristics and treatment patterns in patients with unresolved MDD symptoms by leveraging real-world data. Methods: Patients with unresolved MDD symptoms were identified from the NeuroBlu™ database using the Clinical Global Impression-Severity (CGI-S) scale (01/01/2000-12/31/2020), a 7-point scale with higher scores indicating greater illness severity. The index date was the first visit with CGI-S≥4 within 90-120 days post-diagnosis. Inclusion criteria: CGI-S≥4 (“moderately ill”) at both the first-recorded MDD diagnosis, 90-120 days later and ≥90 consecutive days of an antidepressant (AD) prescription within 180 days prior to the index date. Patient characteristics and treatment patterns were described during the follow-up period (16-365 days post-index date). Only patients who had a recorded medication change were included in the next-observed line of treatment. Results: 3,342 patients with unresolved MDD symptoms were included (mean age 44.4 years; 70.6% female; 60.7% White; psychiatric comorbidities: substance use disorder 24.8%, post-traumatic stress disorder [PTSD] 18.8% and anxiety disorders 18.2%). Among 2,563 patients with a first-line AD prescription who were followed throughout 365 days post-index, 49.5% changed AD prescriptions (ie, switched/dropped/added), 38.2% had no change, and 12.4% discontinued the prescription. Treatment patterns for the second-line treatment were similar, while fewer prescription changes occurred for the third to fifth-line treatment. Conclusions: In patients with MDD and unresolved symptoms, the most prevalent psychiatric comorbidities were substance use disorders, PTSD, and anxiety disorders. Approximately half did not have recorded prescription changes, despite persistent symptoms (CGI-S≥4), highlighting the clinical challenges in managing unresolved MDD using current treatment strategies.Short Description: This retrospective study used real-world data to analyze key characteristics and treatment patterns in 3,342 patients with major depressive disorder (MDD) and unresolved symptoms (defined as Clinical Global Impression-Severity scale ≥4). The most prevalent psychiatric comorbidities were substance use disorders, post-traumatic stress disorder, and anxiety disorders. Despite persistent unresolved symptoms, approximately half the patients did not have recorded prescription changes during the follow-up period, highlighting challenges in managing unresolved MDD with current treatment strategies.Name of Sponsoring Organization(s): Sage Therapeutics, Inc., and Biogen Inc.