Is partial response good enough?

Partial Response has been defined as a 25-50% reduction from baseline in depression scale scores^4,c

^aHave had one major depressive episode in the last year based on data from the 2023 National Survey on Drug Use and Health.²

^bDemonstrated in ~3700 adults with MDD prescribed an antidepressant in the STAR*D study. Remission was defined as QIDS-SR16 ≤5 at 12-14 weeks; 36.8% achieved remission after initial treatment. Statistic extrapolated from STAR*D.²

^cThe HAM-D has been the metric of choice for measuring depression in research settings. Other scales such as the MADRS and the Inventory for Depressive Symptomatology have also been used.⁴

^dThe patient sample received successive acute treatment steps: 3671 patients entered at Step 1; 1439 patients continued at Step 2; 390 patients proceeded to Step 3; 123 patients advanced through all 4 steps. After SSRI monotherapy in Step 1, treatment options included switching medications or augmentation with either medication or cognitive therapy. Adjunctive atypical antipsychotics were not included at any step. Patients who either did not achieve response with a treatment or were unable to tolerate a treatment were encouraged to move to the next step.³

^eIn a meta-analysis, response was defined as a 50% improvement from baseline to endpoint on either the MADRS or HAM-D17. Meta-analysis included 17 randomized trials with 3807 patients (duration range: 4-12 weeks) comparing adjunctive antipsychotic treatment to SSRI/SNRI treatment in adult patients (age range: 18-65 years) with MDD. There was a 68% greater odds of response from the antidepressant + adjunctive antipsychotic group vs the placebo + antidepressant group. Discontinuation due to adverse effects were 9.1% in the adjunctive antipsychotic treatment arm vs. 2.6% in the placebo arm.⁶

HAM-D17, 17-item Hamilton Depression Rating Scale; MADRS, Montgomery-Åsberg Depression Rating Scale; MDD, major depressive disorder; PHQ-9, Patient Health Questionnaire-9; QIDS-SR16, Quick Inventory of Depressive Symptomatology-Self Report 16; SNRI, serotonin and norepinephrine reuptake inhibitor; SSRI, selective serotonin reuptake inhibitor; STAR*D, Sequenced Treatment Alternatives to Relieve Depression.