Thursday, March 10, 2016
Make Way for Possibilities of an Adjunctive Treatment for Major Depressive Disorder
Roueen Rafeyan, MD, Feinberg School of Medicine at Northwestern University
In an industry-sponsored symposium, Dr. Rafeyan explained that many depressed patients do not fully respond to an initial antidepressant, making the next step in treatment either switching to a different antidepressant or adding an adjunctive agent. In pivotal trials, brexpiprazole (Rexulti) added to an antidepressant reduced depressive symptoms, as measured by Montgomery-Åsburg Depression Rating Scale (MADRS) total score, more than an antidepressant plus placebo. Akathisia and weight gain were the most common adverse events and occurred in ≥5% of patients in these studies. The mechanism of action of brexpiprazole in major depressive disorder is unknown, but the efficacy of this drug might be mediated through a combination of partial agonist activity at serotonin 5-HT1A and dopamine D2 receptors and antagonist activity at serotonin 5-HT2A receptors.
