PSYCHIATRY UPDATE 2017

Make Way for Possibilities of an Adjunctive Treatment for Major Depressive Disorder

Greg W. Mattingly, MD, Midwest Research Group and St. Charles Psychiatric Associates, St. Charles, Missouri.

In an industry-sponsored symposium, Dr. Mattingly reported that in the STAR-D study, approximately one-half of patients with major depressive disorder (MDD) did not experience adequate response to an initial selective serotonin reuptake inhibitor and 3 of 4 of those non-responding patients did not achieve full response with a second antidepressant, which prompts consideration of an adjunctive agent. Brexpiprazole (Rexulti) is a partial agonist for serotonin, dopamine, and noradrenergic systems. In pivotal trials as an adjunctive treatment in MDD, brexpiprazole, 2 mg/d, resulted in a statistically significant decrease in Montgomery-Åsburg Depression Rating Scale scores compared with placebo. Most common adverse reactions observed in ≥5% of patients and at least twice the rate of placebo included akathisia and weight increase.

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