The drug landscape for major depressive disorder (MDD) consists of numerous safe and effective treatment options, many of which are available as inexpensive generics. Agents for treating 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 Spravato (Janssen Pharmaceuticals’ esketamine), offer distinct mechanisms of action. Treatment is often a trial-and-error process due to the heterogeneous nature of the patient population and the multitude of drugs available to treat depressive symptoms. As such, the MDD treatment paradigm is highly individualized and complex. This report provides physician insights into prescribing decisions in this complex disease.


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


Current Treatment: Physician Insights provides physician insights on treatment dynamics, prescribing behavior, and drivers of brand use so that marketers can create specific messaging around these treatment dynamics to more effectively increase or defend their market position.

Markets covered: United States

Primary research: Survey of 51 psychiatrists and 51 primary care physicians in the United States.

Key companies: Allergan, AstraZeneca, Bausch Health, Janssen Pharmaceuticals, Lundbeck, Otsuka Pharmaceutical, Sunovion, Takeda Pharmaceutical

Key drugs: Aplenzin, aripiprazole, Latuda, quetiapine XR, Rexulti, sertraline, Spravato, Trintellix

Key insights provided:

  • Factors influencing disease management and treatment decisions.
  • Drivers and constraints of treatment selection.
  • Physician-reported treatment practices and brand-level patient shares.
  • Rationale for changes in treatment approach.
  • Physician insight on persistency and compliance.
  • Physician-reported recent / anticipated changes in brand use or treatment approach.

Table of contents

  • Unipolar Depression - Current Treatment - Detailed, Expanded Analysis (US)

Author(s): Thomas Cronin

Since joining DRG in late 2019, Tom has worked on reports focusing on psychiatric and ophthalmologic disorders for the CNS team. His background is in biochemistry and he previously worked in the intellectual property field as a registered Patent Agent. Prior to joining DRG, Tom was an Intellectual Property Manager in a Boston-based biopharmaceutical company focusing on treating metabolic diseases and disorders. He has also worked for several internationally recognized law firms representing corporate and institutional clients in all matters of life science – related intellectual property.

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