Unipolar depression’s very crowded generic therapy market makes it a challenge for branded agents to gain a strong foothold. SSRIs’ use as first-line treatments and continued position as the patient-share leaders contribute to the challenges that branded therapies face entering this market. However, the need for effective treatments that address the symptoms of the one-third of depression patients who are treatment-resistant is expected to drive growth as newer-to-market therapies (e.g., Lundbeck/Otsuka Pharmaceutical’s Rexulti/RXulti, Allergan’s Vraylar) are incorporated into the treatment paradigm and as emerging therapies targeting underserved cohorts of depression patients (e.g., Janssen’s esketamine, Allergan’s rapastinel, Alkermes’s ALKS-5461) enter the market.


  • What factors drive and constrain the use of branded antidepressants and atypical antipsychotics for the treatment of unipolar depression? What branded therapy is expected to experience the greatest commercial success during the 2017-2027 forecast period?
  • Given the crowded and highly genericized unipolar depression market, what is the commercial potential of key late-phase emerging therapies for unipolar depression?
  • What are the greatest areas of unmet need in the treatment of unipolar depression, and how are the emerging therapies expected to address these unmet needs?
  • Therapies with a more-rapid onset of action are a substantial unmet need in the treatment of unipolar depression. To what extent will emerging therapies, such as Janssen’s esketamine, Allergan’s rapastinel, and Alkermes’s ALKS-5461, capitalize on this unmet need? How will physicians likely incorporate these treatments into their clinical practice?

Markets covered: United States, France, Germany, Italy, Spain, United Kingdom, Japan

Primary research: Approximately 20 country-specific interviews with thought-leading psychiatrists and PCPs/GPs; supported by survey data collected for this and other DRG research.

Epidemiology: 12-month prevalence of unipolar depression by country, segmented by MDD, minor depression, and dysthymia; diagnosed and drug-treated cases of unipolar depression; 12-month prevalence of MDD by country, segmented by chronic pain status; 12-month prevalence of MDD by country, segmented by treatment-resistant status.

Emerging therapies: Phase II: 19 drugs; Phase III: 3 drugs; preregistration: 4 drugs. Coverage of 18 select preclinical and Phase I products.

Market forecast features: Patient-based market forecast extending from 2017 through 2027.

Key companies: Allergan, Alkermes, AstraZeneca, Axsome Therapeutics, Fabre-Kramer, Gedeon Richter, GlaxoSmithKline, Janssen, Lundbeck, Otsuka Pharmaceutical, Pfizer, Sage Therapeutics, Shionogi, Sumitomo Dainippon, Sunovion

Key drugs: Aripiprazole, bupropion HCl SR/XR, duloxetine, escitalopram, Latuda (lurasidone), quetiapine IR/XR, venlafaxine IR/XR, Rexulti/RXulti (brexpiprazole), Trintellix/Brintellix (vortioxetine), Vraylar (cariprazine), ALKS-5461, ASC-01, AXS-05, esketamine, gepirone ER, rapastinel, SAGE-217

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