The treatment landscape for major depressive disorder (MDD), consists of numerous safe and effective treatment options, many of which are available as inexpensive generics. Therapies to treat MDD span multiple drug classes, most notably selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs), while other agents, including the newer-to-market Brintellix (Lundbeck’s vortioxetine), offer distinct mechanisms of action; atypical antipsychotics are typically prescribed for patients with a poor response to antidepressants. Ultimately, given the multitude of drugs available to treat depressive symptoms, coupled with the heterogeneous nature of the patient population, treatment is often a trial-and-error process. As such, the treatment algorithm is complex and highly individualized.


  • What are the drivers and constraints influencing physicians’ treatment decisions for MDD across the EU5? How are patients being treated across different lines of therapy?
  • What drives switching to and from specific brands (e.g., Brintellix [Lundbeck], Cymbalta [Eli Lilly])? How has the availability of generic versions of Cymbalta (duloxetine) and Otsuka’s Abilify (aripiprazole) impacted prescribing?
  • To what extent is polypharmacy prescribed for MDD in the EU5 markets, and what are physicians’ preferred drug class combinations?
  • How has use of key MDD therapies changed in the past year, and what changes do physicians expect in their prescribing of these drugs in one year?


Current Treatment: Provides physician insights on prescribing behavior, treatment paths, and the factors and perceptions driving brand usage so you can understand each brand’s performance and improve or defend your competitive position.

Table of contents

  • Detailed, Expanded Analysis (EU)
    • Key Updates
      • November 2017
    • Introduction to Current Treatment for Unipolar Depression
      • Key Findings
      • Summary Figures
      • Introduction to Current Treatment and Medical Practice for Unipolar Depression
    • Physician Prescribing Practices
      • Key Findings
      • Patient Characteristics
        • Unipolar Depression Is Similar Across Subtype and Age
      • Treatment Practices
        • Most MDD Patients Are Treated with a Polypharmacy Regimen
        • Time to Treatment Start
        • Treatment Rates
        • Patient Share by Product
        • Treatment Duration by Product
        • Use of Nonpharmacological Approaches
        • Line of Therapy Analysis
        • Combination/Regimen/Comedication Analysis
      • Persistency and Compliance
        • Therapeutic Compliance Is Not a Significant Treatment Obstacle
      • Sequencing of Treatment
        • Most Later-Line Patients Are Treated with Branded Therapies
      • Recent/Anticipated Changes in Brand Use/Treatment Approach
        • Use of Brintellix Is Anticipated to Modesty Increase in One Year
    • Physician Insight on Medical Practice
      • Key Findings
      • Drivers of Treatment Selection
        • Factors Influencing Treatment and Disease Management
        • Major Drivers of Brand Use/Treatment
        • Major Obstacles to Brand Use/Treatment
        • Treatment Failure/Brand Issues
    • Methodology
      • Primary Market Research Methodology
    • Appendix
      • Bibliography
      • Primary Market Research

Author(s): Audreza Das, P.G. Dip

Audreza Das is a Senior Analyst in the CNS/Ophthalmology team at Decision Resources Group She has authored content across indications, including neuropathic pain, age-related macular degeneration, treatment-related depression, painful diabetic neuropathy, and migraine. Ms. Das has previously worked at Novo Nordisk, as a Market Analyst for European markets. Previous experience at a SME, included developing disease competitive landscapes, covering global conferences etc. Ms. Das received her degree in Biotechnology from Birla Institute of Technology, a deemed university and her Diploma in Cancer Immunology & Biotechnology from University of Nottingham.

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