Prevalence of Potential Drug-Drug Interactions and Pre-existing Conditions for Adverse Events in Augmentation Therapies Among Patients With Treatment-resistant Depression
Psych Congress, 2020
A team including researchers from Analysis Group, Janssen Scientific Affairs LLC, and New York Medical College found that, in augmentation therapy, treatment-resistant depression (TRD) carries higher likelihood of potential drug-drug interactions and the presence of pre-existing conditions for adverse events than does the standard major depressive disorder (MDD). TRD, which impacts approximately 30% of adults with pharmacologically treated MDD, commonly indicates a failure to respond to two or more different antidepressant treatments in a current episode of MDD. Augmentation therapy for TRD involves usage of drugs, such as atypical antipsychotics, in an effort to increase the efficacy of antidepressant therapies the patient is already taking. This study, which was presented at Psych Congress 2020, aimed to fill a research gap and aid decision making around risks related to non-antidepressant augmentation therapies in patients with TRD.
The researchers, including Managing Principal Patrick Lefebvre, Vice President Dominic Pilon, Managers Masha Zhdanava and Carmine Rossi, and Associate Laura Morrison, conducted a retrospective, matched-cohort study that compared 3,414 patients with TRD 1:1 to patients with non-TRD MDD. The results indicated that patients with TRD were 12.92 times more likely to have at least two potential drug-drug interactions than patients with MDD, and 6.35 times more likely to have at least three. The patients with TRD were also 1.33 times more likely to have at least one pre-existing condition, including cardiovascular conditions, for adverse events related to any non-antidepressant augmentations. The authors concluded that patients with TRD face a poorer prognosis, and clinicians face particular challenges helping them, given the combination of limited research to guide clinical decision making, patients’ likelihood of potential drug-drug interactions and pre-existing conditions for adverse events, and insurance payer pre-authorization policies that may complicate access to novel treatments.