The following article is a part of conference coverage from Psych Congress 2020 Virtual Experience, held virtually from September 10 to 13, 2020. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the Psych Congress 2020.


Pre-existing conditions for adverse events and potential drug-drug interactions limit safe, non-antidepressant augmentation options for patients with treatment-resistant depression (TRD), according to research presented at Psych Congress 2020, held September 10-13, 2020.

Researchers conducted a retrospective matched cohort study in which patients with TRD were matched 1:1 and compared with patients with non-TRD major depressive disorder (MDD). Among the TRD cohort, the date of TRD onset was defined as the initiation of a new antidepressant treatment course after the absence of response to 2 antidepressant treatment courses of adequate dose and duration. The index date for non-TRD patients was randomly selected among all dates with an antidepressant medication claim.

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Participants were identified through MarketScan® Databases. Patients were excluded from the study if they had a confirmed diagnosis for specific psychiatric comorbidities during the study period, <12 months of continuous insurance eligibility prior to the index date, <3 months of continuous insurance eligibility after the index date, and were <18 years of age at the index date.

The primary outcome measure was a comparison of pre-existing conditions in the 12 months pre-index and potential severe/moderate drug-drug interactions in the 3 months pre/post-index date associated with specific atypical antipsychotics, buspirone, psychostimulants, anticonvulsants, thyroid hormone, and lithium between both cohorts.  

A total of 3414 patients with TRD (mean age, 39.7 years; 68.6% women) were identified and matched to those with non-TRD MDD. Among patients with TRD, the prevalence of having at least 1 pre-existing condition related to an AE for any non-antidepressant augmentation was 82%. Results of the analysis found that patients with TRD vs non-TRD MDD had a 1.33 times higher odds of at least 1 pre-existing condition for adverse events, including higher odds for cardiovascular conditions. Additionally, patients with TRD vs non-TRD MDD had 12.92 and 6.35 times higher odds of at least 2 and at least 3 drug-drug interactions, respectively.

“Effective treatment options for patients with TRD who failed previous treatment courses with [antidepressants] may be limited given the high prevalence of pre-existing conditions for [antidepressants] and potential [drug-drug interactions] associated with non-[antidepressant] augmentation therapies,” the study authors reported.

Disclosure: This study was funded by Janssen Scientific Affairs, LLC.

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Zhdanava M, Karkare S, Pilon D, et al. Prevalence of pre-existing conditions for adverse events and potential drug-drug interactions associated with augmentation therapies among patients with treatment-resistant depression. Presented at: Psych Congress 2020 Virtual Experience; September 10-13, 2020. Poster 191.

This article originally appeared on Psychiatry Advisor