Huang MY, Smith A, Brister T, Counts N, Sweeney C, McSorley D, Suthoff E, Parikh S. Report from a national survey of depression treatment: patient experience on antidepressant medications for major depressive disorder. Poster presented at the AMCP Nexus 2022; October 11, 2022. National Harbor, MD. [abstract] J Manag Care Pharm. 2022 Oct; 28(10-a):S59-60.

BACKGROUND: Antidepressant therapy (ADT) have been the standard of care for major depressive disorder (MDD) for decades. Treatment goals for MDD include relief of depressive symptoms, alleviating functional impairments, and relapse prevention. Slow onset of action, lack of symptom relief, and adverse events associated with ADT may result in discontinuation of therapy, which can lead to worsening of symptoms or relapse. This study evaluated patients’ experience with their ADT.

METHODS: This was a cross-sectional, web-based survey conducted in the United States with adult patients who self-reported a clinician diagnosis of MDD or depression. Patients were identified and recruited to complete the survey through the Depression and Bipolar Support Alliance (DBSA) databases or via a proprietary patient panel. Eligible patients reported previous or current treatment with ≥ 1 ADT for ≥ 2 weeks. Data were collected during May 2021 to November 2021.

RESULTS: Among the 585 participants taking ≥ 1 ADT, the mean age of diagnosis with depression was 27 years, and the mean number of years between onset of symptoms until diagnosis was 8 years. The mean number of months since the most recent depressive episode was 16 months. Most participants reported taking their current ADT for ≥ 6 months (89%). More than half of participants (57%) had taken ≥ 5 ADT in their lifetime, and the top reason for changing ADT was non-relief of symptoms (78%). More than half of participants “strongly agreed” or “somewhat agreed” that switching ADT made them feel like no medication was going to work (72%) and that every medication they tried would cause side effects (66%). More than half were “not at all satisfied” to “a little satisfied” with improvement in depressive symptoms (60%) and the idea that the ADT could prevent symptoms from returning (58%). Nearly half (45%) reported missing or skipping a dose of their ADT in an average month. Even with current ADT use, approximately 60% of participants rated their mental health and satisfaction with social activities and relationships as “poor” to “fair.” Nearly 40% of participants rated their quality of life (QOL) as “poor” to “fair.”

CONCLUSIONS: Patients with MDD can suffer from depressive symptoms for many years before being diagnosed with depression. Patients who currently use ADT to treat their depression reported struggling with multiple medication switches throughout their lifetime, issues with QOL, and low satisfaction with their current ADT. This represents an unmet need for more effective treatment options for patients with MDD.

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