Details

Autor(en) / Beteiligte

• Fugger, Gernot
• Bartova, Lucie
• Fabbri, Chiara
• Fanelli, Giuseppe
• Zanardi, Raffaella
• Dold, Markus
• Kautzky, Alexander
• Rujescu, Dan
• Souery, Daniel
• Mendlewicz, Julien
• Zohar, Joseph
• Montgomery, Stuart
• Serretti, Alessandro
• Kasper, Siegfried

Titel

The sociodemographic and clinical phenotype of European patients with major depressive disorder undergoing first-line antidepressant treatment with NaSSAs

Ist Teil von

• Journal of affective disorders, 2022-09, Vol.312, p.225-234

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Since selective serotonin reuptake inhibitors, that are recommended as first-line antidepressant psychopharmacotherapy for major depressive disorder (MDD), may not be the optimal choice for every patient, antidepressants with different modes of action exerting a distinct set of expectant effects, represent a valuable alternative. Despite the previously observed increased prescription rates of noradrenergic and specific serotonergic antidepressants (NaSSAs) - particularly mirtazapine - in Europe, the individual profiles of patients primarily prescribed NaSSAs in real-world settings have not been systematically investigated yet. In this secondary analysis based on a European, cross-sectional, naturalistic, multicenter study involving 1410 adult males and females with primary MDD, sociodemographic and clinical variables were compared between patients dispensed NaSSAs and those with alternative first-line antidepressants. Hereby, NaSSAs were administered in 8.6 % of the sample (mirtazapine: n = 114, mianserin: n = 7). We detected associations with older mean age, male sex, unemployment, as well as additional melancholic and catatonic features, inpatient treatment, lower mean daily-dosages of the administered antidepressants but higher rates of augmentation with low-potency antipsychotics, and greater mean reductions of depressive symptoms during their current major depressive episodes. Although the study design is unsuitable to draw any causal conclusions, our findings provide a realistic picture of patients eligible for first-line antidepressant treatment with NaSSAs, especially mirtazapine, and underscore the role of this AD substance class in severe MDD. Further, they may represent a promising basis for future systematic research focusing on precision diagnostics and treatment in MDD, that would ideally result in faster responses and better outcomes, especially in the so-called difficult-to-treat conditions including treatment resistant depression. •Antidepressants with different modes of action represent valuable alternatives to SSRIs.•NaSSAs were administered in 8.6% of 1410 MDD patients who were rather older, male, unemployed, inpatients.•NaSSAs went along with melancholic/catatonic features, lower antidepressant doses, antipsychotic augmentation, greater symptom reduction.•This multicenter and naturalistic study reflects real-world treatment settings in MDD.•The cross-sectional study design and the lack of randomization are limitations.