title: Switching from Inadequate Adjunctive or Combination Treatment Options to Brexpiprazole Adjunctive to Antidepressant: An Open-Label Study on the Effects on Depressive Symptoms and Cognitive and Physical Functioning.
abstract: Approximately 50% of patients with major depressive disorder do not respond adequately to their antidepressant treatment, underscoring the need for more effective treatment options. The objective of this study was to investigate the effect of adjunctive brexpiprazole on depressive symptoms in patients with major depressive disorder who were not responding to adjunctive or combination therapy of their current antidepressant treatments with several different classes of agents (NCT02012218).
  
  
  
  In this 6-week, open-label, phase 3b study, patients with major depressive disorder who had an inadequate response to ≥1 adjunctive or combination therapy, in addition to history of ≥1 failure to monotherapy antidepressant treatment, were switched to adjunctive brexpiprazole. Efficacy was assessed by change from baseline to week 6 in Montgomery-Åsberg Depression Rating Scale total score. Patient functioning was assessed using the Sheehan Disability Scale and the Cognitive and Physical Functioning Questionnaire. Safety and tolerability were also assessed.
  
  
  
  A total of 51/61 (83.6%) patients completed 6 weeks of treatment with adjunctive brexpiprazole. Improvements in depressive symptoms were observed (least squares mean change from baseline to week 6 in Montgomery-Åsberg Depression Rating Scale total score, -17.3 [P < .0001]) as well as improvements in general and cognitive functioning (mean changes from baseline to week 6: Sheehan Disability Scale, -3.1 [P < .0001]; Massachusetts General Hospital-Cognitive and Physical Functioning Questionnaire, -9.2 [P < .0001]). The most common adverse event was fatigue (14.8%); akathisia was reported by 8.2% of patients.
  
  
  
  In patients with major depressive disorder who had switched to open-label adjunctive brexpiprazole following inadequate response to previous adjunctive or combination therapy, improvements were observed in depressive symptoms, general functioning, cognitive function, and energy/alertness.
authors: Massachusetts General Hospital, Boston, MA; Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan; Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ; H. Lundbeck A/S, Valby, Denmark.
authors: Maurizio
authors: M
authors: Fava
authors: Massachusetts General Hospital, Boston, MA; Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan; Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ; H. Lundbeck A/S, Valby, Denmark.
authors: Takao
authors: T
authors: Okame
authors: Massachusetts General Hospital, Boston, MA; Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan; Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ; H. Lundbeck A/S, Valby, Denmark.
authors: Yuki
authors: Y
authors: Matsushima
authors: Massachusetts General Hospital, Boston, MA; Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan; Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ; H. Lundbeck A/S, Valby, Denmark.
authors: Pamela
authors: P
authors: Perry
authors: Massachusetts General Hospital, Boston, MA; Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan; Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ; H. Lundbeck A/S, Valby, Denmark.
authors: Emmanuelle
authors: E
authors: Weiller
authors: Massachusetts General Hospital, Boston, MA; Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan; Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ; H. Lundbeck A/S, Valby, Denmark.
authors: Ross A
authors: RA
authors: Baker
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000068180:Aripiprazole / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects; D003865:Major Depressive Disorder / Q000188:drug therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D000069348:Quetiapine Fumarate / Q000627:therapeutic use; D015363:Quinolones / Q000009:adverse effects / Q000627:therapeutic use*; D012890:Sleep / Q000187:drug effects; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D000697:Central Nervous System Stimulants; D015363:Quinolones; D013876:Thiophenes; D016642:Bupropion; C000591922:brexpiprazole; D000069348:Quetiapine Fumarate; D000068180:Aripiprazole
keywords: adjunctive; antidepressant; brexpiprazole; major depressive disorder; switching