Short- and Long-Term Antidepressant Clinical Trials for Major Depressive Disorder in Youth: Findings and Concerns

Abstract Brexpiprazole is an atypical antipsychotic that works as a partial agonist at serotonin 5-hydroxytryptamine1A and dopamine D2 receptors and an antagonist at serotonin 5-hydroxytryptamine2A. It has US Food and Drug Administration approval for monotherapy treatment of schizophrenia and adjunctive treatment to antidepressants for major depressive disorder. Two phase-3 clinical trials demonstrated efficacy and relatively fair tolerability with regard to adverse effects for each indication. Akathisia was frequently reported in the major depressive disorder trials but less so in the schizophrenia trials. Significant increases in body weight and triglycerides were seen across all studies. Brexpiprazole appears to be a viable option for treating an acute exacerbation of schizophrenia requiring hospitalization or adjunctive treatment of major depressive disorder in patients who showed an inadequate response to 1 to 3 antidepressants. Further clinical trials are warranted to determine the long-term efficacy of brexpiprazole, and comparison trials would be beneficial to establish its place in therapy.

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Impact of Drug Tolerability on the Selection of Antidepressant Treatment in Patients With Major Depressive Disorder

CNS Spectrums ◽

10.1017/s1092852900026353 ◽

2009 ◽

Vol 14 (S12) ◽

pp. 8-14 ◽

Cited By ~ 10

Author(s):

Lawrence D. Ginsberg

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Antidepressant Treatment ◽

Tolerability Profile ◽

Major Depressive ◽

Treatment Side Effects ◽

Drug Tolerability ◽

Short And Long Term ◽

Selection Of

AbstractDespite significant progress in the development of antidepressant therapies, tolerability remains an important factor associated with the selection of appropriate antidepressant treatment. Side effects commonly reported by depressed patients taking antidepressants include weight gain, sexual dysfunction, and gastrointestinal effects. Tolerability issues associated with antidepressants can negatively impact treatment outcomes for patients with major depressive disorder. In addition, a drug's tolerability profile substantially influences a physician's choice of specific antidepressant therapy. Despite the availability of many antidepressants, empirical clinical evidence to guide physicians in making the best choice is limited and not always clear. Thus, it is key for clinicians to understand the short- and long-term outcomes and side effect profiles of the available antidepressants.

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The impact of major depressive disorder on the short- and long-term outcome of Crohn's disease treatment with infliximab

Alimentary Pharmacology & Therapeutics ◽

10.1111/j.1365-2036.2005.02535.x ◽

2005 ◽

Vol 22 (2) ◽

pp. 101-110 ◽

Cited By ~ 127

Author(s):

P. PERSOONS ◽

S. VERMEIRE ◽

K. DEMYTTENAERE ◽

B. FISCHLER ◽

J. VANDENBERGHE ◽

...

Keyword(s):

Major Depressive Disorder ◽

Crohn’S Disease ◽

Depressive Disorder ◽

Disease Treatment ◽

Major Depressive ◽

Term Outcome ◽

Long Term Outcome ◽

Short And Long Term ◽

The Impact

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Vortioxetine: a meta-analysis of 12 short-term, randomized, placebo-controlled clinical trials for the treatment of major depressive disorder

Journal of Psychiatry and Neuroscience ◽

10.1503/jpn.140120 ◽

2015 ◽

Vol 40 (3) ◽

pp. 174-186 ◽

Cited By ~ 36

Author(s):

Chi-Un Pae ◽

Sheng-Min Wang ◽

Changsu Han ◽

Soo-Jung Lee ◽

Ashwin Patkar ◽

...

Keyword(s):

Clinical Trials ◽

Major Depressive Disorder ◽

Depressive Disorder ◽

Meta Analysis ◽

Controlled Clinical Trials ◽

Short Term ◽

Major Depressive

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The Long-Term Effects of Mindfulness-Based Cognitive Therapy as a Relapse Prevention Treatment for Major Depressive Disorder

Behavioural and Cognitive Psychotherapy ◽

10.1017/s135246581000010x ◽

2010 ◽

Vol 38 (5) ◽

pp. 561-576 ◽

Cited By ~ 42

Author(s):

Kate L. Mathew ◽

Hayley S. Whitford ◽

Maura A. Kenny ◽

Linley A. Denson

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Cognitive Therapy ◽

Relapse Prevention ◽

Mindfulness Practice ◽

Long Term Effects ◽

Major Depressive ◽

Strong Negative Correlation ◽

Group 3

Background: Mindfulness-based Cognitive Therapy (MBCT) is a relapse prevention treatment for major depressive disorder. Method: An observational clinical audit of 39 participants explored the long-term effects of MBCT using standardized measures of depression (BDI-II), rumination (RSS), and mindfulness (MAAS). Results: MBCT was associated with statistically significant reductions in depression from pre to post treatment. Gains were maintained over time (Group 1, 1–12 months, p = .002; Group 2, 13–24 months, p = .001; Group 3, 25–34 months, p = .04). Depression scores in Group 3 did begin to worsen, yet were still within the mild range of the BDI-II. Treatment variables such as attendance at “booster” sessions and ongoing mindfulness practice correlated with better depression outcomes (p = .003 and p = .03 respectively). There was a strong negative correlation between rumination and mindful attention (p < .001), consistent with a proposed mechanism of metacognition in the efficacy of MBCT. Conclusion: It is suggested that ongoing MBCT skills and practice may be important for relapse prevention over the longer term. Larger randomized studies of the mechanisms of MBCT with longer follow-up periods are recommended.

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