Managing Partial Response to Antidepressant Therapy

Response rates to antidepressant drug therapy in people with unipolar depression are often less than optimal. Partial response is seen in about one third of those treated with pharmacologic agents. In this Roundtable, Drs George Papakostas, Manish Jha, and Olga Brawman-Mintzer examine clinical strategies for patients with partial antidepressant resistance, focusing on identifying, assessing, and treating this population.

For patients with unipolar depression, response rates to antidepressant drug therapy vary and partial response affects about one third of these patients.

In this virtual Roundtable, Drs George Papakostas, Manish Jha, and Olga Brawman-Mintzer discuss the best practices for identifying and treating partial response to antidepressant therapy.

First, the panelists discuss the value of tools for measurement-based care, such as the Massachusetts General Hospital Antidepressant Treatment Response Questionnaire [MGH-ATRQ] for identifying treatment resistance. They also discuss the importance of structured clinical interviews, including the Mini-International Neuropsychiatric Interview (MINI) and Composite International Diagnostic Interview (CIDI). Together, these protocols provide clinicians with methods to identify partial response as well as guidance for individualizing patient care.

The panelists then address types of therapeutic optimization, including titration, augmentation, and switching.

The panelists conclude their discussion by considering the relative safety and tolerability of antidepressant therapy for patients with partial response to pharmacologic treatment.

About the Panel

George Papakostas, MD Photo

George Papakostas, MD

  • Professor of Psychiatry
  • Harvard Medical School
  • Associate Executive Director
  • Clinical Trial Network and Institute
  • Department of Psychiatry
  • Massachusetts General Hospital
  • Boston, Massachusetts
Manish K. Jha, MBBS Photo

Manish K. Jha, MBBS

  • Assistant Professor
  • Department of Psychiatry
  • UT Southwestern Medical Center
  • Dallas, Texas
Olga Brawman-Mintzer, MD Photo

Olga Brawman-Mintzer, MD

  • Professor
  • Department of Psychiatry and College of Health Professions
  • Medical University of South Carolina
  • Co-Director
  • SC Institute for Brain Health
  • Ralph H. Johnson VA Healthcare System
  • Medical Center
  • Charleston, South Carolina

George Papakostas, MD, has disclosed the following relevant financial relationships:
Has served as a consultant for Abbott Laboratories; Acadia Pharmaceuticals, Inc*; Alkermes, Inc; Almatica*; Alphasigma USA Inc*; AstraZeneca PLC; Arrivo Bioventures; Sirtsei Phamaceuticals; Avanir Pharmaceuticals; Axsome Therapeutics*; Boehringer Ingelheim; Boston Pharmaceuticals, Inc.*; Brainsway Ltd; Bristol Myers Squibb Company; Cala Health*; Cephalon Inc.; Dey Pharma, L.P.; Eleusis Health Solutions Ltd*; Eli Lilly Co.; Genentech, Inc*; Genomind, Inc*; GlaxoSmithKline; Evotec AG; H. Lundbeck A/S; Inflabloc Pharmaceuticals; Janssen Global Services LLC*; Jazz Pharmaceuticals; Johnson & Johnson Companies*; Methylation Sciences Inc; Monopteros Therapeutics*; Mylan Inc*; Neurocenria; Novartis Pharma AG; One Carbon Therapeutics, Inc*; Osmotica Pharmaceutical Corp.*; Otsuka Pharmaceuticals; PAMLAB LLC; Pfizer Inc.; Pierre Fabre Laboratories; Praxis Precision Medicines*; Ridge Diagnostics (formerly known as Precision Human Biolaboratories); Sage Therapeutics*; Shire Pharmaceuticals; Sunovion Pharmaceuticals; Taisho Pharmaceutical Co, Ltd*; Takeda Pharmaceutical Company LTD; Theracos, Inc.; Wyeth, Inc.
*Consulting activity undertaken on behalf of Massachusetts General Hospital
Has received honoraria (for lectures or consultancy) from: Abbott Laboratories; Acadia Pharmaceuticals Inc; Alkermes Inc; Alphasigma USA Inc; Asopharma America Central Y Caribe; Astra Zeneca PLC; Avanir Pharmaceuticals; Boehringer Ingelheim; Bristol Myers Squibb Company; Brainsway Ltd; Cephalon Inc.; Dey Pharma, L.P.; Eli Lilly Co.; Evotec AG; Forest Pharmaceuticals; GlaxoSmithKline; Inflabloc Pharmaceuticals; Grunbiotics Pty LTD; Hypera S.A.; Jazz Pharmaceuticals; H. Lundbeck A/S; Medichem Pharmaceuticals, Inc; Meiji Seika Pharma Co. Ltd; Novartis Pharma AG; Otsuka Pharmaceuticals; PAMLAB LLC; Pfizer; Pharma Trade SAS; Pierre Fabre Laboratories; Ridge Diagnostics (formerly known as Precision Human Biolaboratories)

Manish K. Jha, MBBS, has disclosed the following relevant financial relationships:
Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Eleusis Therapeutics Inc; Janssen Global Services; Janssen Scientific Affairs Worldwide Clinical Trials; Guidepoint Global
Serve(d) as a speaker or a member of a speakers bureau for: North American Center for Continuing Medical Education; Medscape/WebMD; Clinical Care Options; Global Medical Education
Received research grant from: Acadia; Neurocrine; Navitor/Supernus; Janssen R&D
Received income in an amount equal to or greater than $250 from: PCORI; PASA
Section Editor for: Psychiatry & Behavioral Health Learning Network

Olga Brawman-Mintzer, MD, has disclosed the following relevant financial relationships:
Received research grant from: Merck; NIA/ATRI; NIA/ADCS; AGeneBio; DoD; Avanir; PCORI