A New Option for Depressed Patients Who Do Not Respond to Antidepressant Medications

Thase presents the study by Sachs et al which describes the main findings of a randomized controlled trial of the second-generation antipsychotic (SGA) cariprazine as an adjunctive treatment for patients with major depressive disorder (MDD). Because not all of the participants had received two or more adequate trials of therapy with standard antidepressants in the current episode, the sample does not technically meet regulatory criteria for treatment-resistant depression but does represent the pool of depressed patients who are considered for second- or third-line treatment options. This paper is important for a number of reasons. First, MDD is a common and potentially disabling condition that is recognized as one of the world's greatest public health problems. Second, although prompt recognition and vigorous treatment is inarguably the best strategy to reduce the profound suffering and illness burden attributable to MDD, many depressed people--perhaps up to 40%--do not respond to sequential trials of standard antidepressant medications.