Decision Resources, one of the world's leading research and advisory firms focusing on pharmaceutical and healthcare issues, finds that, despite physicians' desire to prescribe more serotonin/norepinephrine reuptake inhibitors (SNRIs), Forest Laboratories' Lexapro retains leadership among first-line therapies in the treatment of major depression. According to the new report entitled Treatment Algorithms in Major Depression, selective serotonin reuptake inhibitors (SSRIs), which include Lexapro, serve 61 percent of patients on first-line therapy. Surveyed physicians say the reasons for SSRIs being so heavily used are efficacy, cost and physician familiarity. SNRIs are relegated to later lines of therapy because they are more expensive than SSRIs. However, 60 percent of surveyed psychiatrists and 47 percent of surveyed primary care physicians (PCPs) say SNRIs are more efficacious than SSRIs against depression; 44 percent of surveyed psychiatrists and 43 percent of surveyed PCPs believe SNRIs have fewer sexual side effects than SSRIs, a major complaint of patients taking antidepressants.

The report also finds Wyeth's Pristiq will benefit from key changes in physician prescribing patterns in the treatment of major depression. Physicians are expected to move patients from Effexor to Pristiq-a newly approved SNRI- over the next two years. Wyeth's Effexor, the current leader among SNRIs, will face a surge in generic competition in 2010. Pristiq will begin to replace Wyeth's Effexor XR and Lilly's Cymbalta, especially in psychiatrists' practices.

"We expect two key changes in the treatment of major depression over the next two years: increased use of SNRIs in first-line therapy and more widespread prescribing of atypical antipsychotics as adjunct therapies," said Michael Malecki, Ph.D., analyst at Decision Resources. "Fifty-six percent of surveyed psychiatrists and 48 percent of surveyed PCPs say they will increase their use of SNRIs in first-line therapy. Additionally, 48 percent of surveyed psychiatrists and 40 percent of surveyed PCPs will increase their use of antipsychotics as adjunct therapies."

About Treatment Algorithm Insight Series

Decision Resources combines in-depth primary research with the most extensive claims-based longitudinal patient-level data from PharMetrics® to provide exceptional insight into physicians' prescribing trends and the factors that drive therapy product choice, from diagnosis through multiple courses of treatment, for a specific disease.

For each disease examined, Decision Resources' Treatment Algorithm Insight Series provide the following:

  -- Summary of U.S. medical practice based on interviews with leading      experts in the field.   -- Qualitative diagnosis/referral/treatment algorithm for the United      States.   -- Drug usage by lines of therapy (1st, 2nd, 3rd line).   -- Discussion of key freeform combinations by lines of therapy.   -- Product share (class and specific compound level) within each line of      therapy (1st, 2nd, 3rd line).   -- Progression of therapy from key 1st line products.   -- Pathway to key therapies from previous therapies.   -- Qualitative analysis of two-year forecast incorporating upcoming      launches, changes in reimbursement, etc.     About Decision Resources 

Decision Resources, Inc. ( is a world leader in research publications, advisory services, and consulting designed to help clients shape strategy, allocate resources, and master their chosen markets. Decision Resources is a Decision Resources, Inc. company.

All company, brand, or product names contained in this document may be trademarks or registered trademarks of their respective holders.

  For more information, contact:    Elizabeth Marshall   Decision Resources, Inc.   781-296-2563 

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SOURCE: Decision Resources

CONTACT: Elizabeth Marshall of Decision Resources, Inc.,

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